Anesthesiology is a field where much emphasis is placed on patient safety through the prevention of error. A different approach to prevent perioperative complications in children undergoing anesthesia involves helping caregivers stop smoking.

The literature purports an alarming 10 times increase in the incidence of both perioperative laryngospasm and bronchospasm in pediatric patients whose parents reported environmental tobacco smoke exposure. The presence of a respiratory tract infection or need for intubation increases these risks (

von Ungern-Sternberg
BS
, et al
Lancet
.
2010
;
376
:
773
-783
).

Other studies show that the effects of secondhand smoke exposure continue into the recovery period and impact the patients’ response to certain medications such as rocuronium (

Reisli
R
, et al
Paediatr Anaesth
.
2004
;
14
:
247
-250
). Furthermore, many children, especially those with pre-existing pulmonary disease, recent upper respiratory infection or other significant co-morbidities, will...

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