Smoking perioperative sensitize, educate and involve all stakeholders in health

We must educate, train and involve all stakeholders in the health care of smokers before surgery (doctor, emergency room, anesthesiologist, surgeon, nurse, nursing assistant, medical specialist) advocate of French experts.

Under the aegis of the French Anesthesia and Intensive Care Society (Sfar), the French Association of Surgery (AFC) and the French Office of Tobacco Prevention (OFT), experts have, in fact, met to review the medical literature and issue recommendations regarding perioperative smoking.

A summary of their discussions was presented to Congress Sfar to be subjected to debate. The text is published in the French Journal of anesthesia and resuscitation (Afar), said Professor Bertrand Dautzenberg (Pitié-Salpêtrière, Paris).

Experts recommend how, since the announcement of surgery while caring implement the means at its disposal to help smokers to stop, by taking care of himself or by contacting a specialist or the physician or another physician or trained midwife.

Nicotine replacement therapy and other drug assistance psychobehavioural support can be used. The simple reduction of smoking in nicotine replacement may be recommended perioperative patients who will not or can not stop, and as a first step towards stopping.

In this regard, Dr. Anne Borgne (Jean Verdier Hospital, Bondy, Seine-Saint-Denis) noted that the substituted nicotine showed a different kinetics of inhaled nicotine and did not cause these complications.

The authors also recommend that "smokers who stopped smoking for a surgical procedure must have at the time of hospitalization for further treatment before insiders to stop."

In fact, they describe the role of different actors in health according to the time before surgery, before and after hospitalization.

A doctor in the audience suggested that this support is included in the tasks of physician provided under the reform of the health insurance, the latter to compete in preventive care, including screening and the health education.

For urgent interventions, withdrawal symptoms appear between two and six hours after the start of abstinence and warrant supported by a nicotine replacement.

"In each department or hospital procedures support smoking should be established, specifying the role of each in order to diagnose and treat smoking. Cooperation mobile team of smoking cessation in a binding activity is desirable ", experts say.

The latter added that "NRT is too little used for inpatients and should benefit more patients." According to Dr. Borgne, it "would also require hospital pharmacies to develop in NRT because it is far from always the case," even though they are reimbursed for hospitalized patients, noted a doctor the audience