Summary
Introduction:
This text reviews the literature on electronic nicotine delivery systems (ENDS), or e-cigarettes, with a focus on their effects that could influence anesthetic and surgical outcomes. The text also includes a meta-analysis of articles published between 2016 and 2018 reporting injuries from exploding ENDS.
Key Points:
* ENDS deliver nicotine, which is addictive and a cardiac stimulant, and are linked to increased risk of heart disease and myocardial infarction.
* ENDS deliver vapors of solvents, flavorings, and other chemicals that can cause chronic and acute respiratory diseases.
* The text identifies 15 articles reporting injuries from ENDS fires and explosions to 93 patients, mostly young (mean age = 31.6 years) and male (91%).
* The most common injury sites were the thigh (62%) and hand (33%).
* The anesthetist should identify ENDS users and understand the risks of ENDS use.
* The nicotine in ENDS has been linked to increased risk of heart disease and myocardial infarction.
* ENDS use may pose a cancer risk.
* however, ENDS are somewhat less dangerous than cigarettes and are used as smoking cessation devices.
Main Message:
The increasing popularity of ENDS, particularly among youth, poses significant health risks, including diseases of the respiratory and cardiovascular systems and potential cancer risk. Despite the dangers of ENDS use, it is less dangerous than smoking cigarettes in the perioperative period. Explicit questions about ENDS use should be added to preanesthesia interview checklists, and patients who use ENDS, particularly those with lung disease, atherosclerosis, or a history of smoking, should be encouraged to abstain before and after anesthesia. hospital signage should be updated to explicitly forbid the use of ENDS on hospital property.
Citation
harris DE, Foley EM. anesthesia Implications of Patient Use of Electronic Cigarettes. aaNa journal. 2020;88(2):135-140.
