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Angiology
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The Physiological Effects of Short-term Smoking Cessation in Claudicants

K.J. Dickinson, BSc, MRCS

Leeds Vascular Institute, Leeds General Infirmary, Leeds, United Kingdom, kdickinson0{at}hotmail.com

A.J. Cockbain, BSc, MRCS

Leeds Vascular Institute, Leeds General Infirmary, Leeds, United Kingdom

W. MacDonald

Respiratory Function Laboratory, Leeds General Infirmary, Leeds, United Kingdom

M. Shah, FRCA

Department of Anaesthesia, Leeds General Infirmary, Leeds, United Kingdom

S. Homer-Vanniasinkam, BSc, FRCS Ed, FRCS

Leeds Vascular Institute, Leeds General Infirmary, Leeds, United Kingdom

Introduction: Smoking contributes to atherosclerosis and causes significant postoperative morbidity. New antismoking law forces short-term pre-operative abstinence. Demonstrable clinical benefit might motivate complete cessation. Our aim was to determine the effects of 24-hr smoking cessation on cardiorespiratory function and claudication distance. Methods: Smoking claudicants were randomized to 24hr smoking or abstinence. Following these separate periods, cardiopulmonary exercise testing was performed. Pre- and post-exercise, serum lactate and ankle brachial pressure index (ABPI) were measured. During exercise, cardiorespiratory function, initial and absolute claudication (IC,AC) distances and visual analogue scores (VAS) of pain were recorded. Results: 16 patients completed both tests. IC, AC and VAS were unchanged with abstinence (P = .43, .66, .96, .83). ABPI drop post-exercise was unchanged with abstinence (P = .08, .09). Cardiorespiratory function was not affected by smoking cessation. Conclusion: Cardiorespiratory function and claudication symptoms are unchanged following 24-hr smoking cessation., No deterioration in respiratory function is important when considering anaesthetic administration. However, lack of symptomatic improvement may discourage patients from abstaining. Further investigation should determine correlation between short-term abstinence and postoperative morbidity.

Key Words: Smoking • atherosclerosis • peripheral arterial disease

This version was published on April 1, 2009

Angiology, Vol. 60, No. 2, 159-163 (2009)
DOI: 10.1177/0003319708325448
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