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Table · dataset · 2026

Table 1_Perioperative challenges: does smoking compromise high-flow nasal oxygen efficacy in obese Men? A randomised controlled trial.xlsx

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Background<p>Obesity poses a risk of airway-related incidents during anaesthesia.

Description

Perioperative pre-oxygenation in obese patients often involves high-flow nasal oxygen to reduce the risk of airway complications. Nevertheless, few studies have investigated the effect of smoking habits on apnoeic oxygenation with high-flow nasal cannula in obese men.</p>Objective<p>This study aimed to explore the effects of smoking on the safe apnoea duration in obese males.</p>Design<p>Prospective, randomised, controlled study.</p>Setting<p>University-affiliated hospital from September 2024 to May 2025.</p>Patients<p>Sixty obese males who underwent abdominal (non-thoracic) surgery, aged between 18 and 65 years.</p>Interventions<p>Patients were categorised into two groups according to their smoking habits: smokers (Group S) and never smokers (Group NS).

Smokers were defined as current smokers consuming at least 10 cigarettes daily for over 2 years, and had continued smoking up to at least 14 days prior to surgery, while non-smokers had no history of smoking. All patients underwent intravenous anaesthesia induction and received 5 min of high-flow nasal oxygen (60 L/min) before induction. Following anaesthesia induction, patients remained apnoeic until their peripheral oxygen saturation dropped to 92%.</p>Main outcome measures<p>The primary outcome was the comparison of safe apnoea duration between the two groups after receiving 5-minute pre-oxygenation with high-flow nasal oxygen.</p>Results<p>Sixty patients were enrolled (30 smokers and 30 non-smokers).

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Never smokers had a significantly longer safe apnoea duration than smokers, with median [IQR] values of 373.5 (106.25) vs. 262.5 (138.5) seconds, P = 0.012. However, the incidence of postoperative nausea and vomiting was slightly higher in never smokers than in smokers, with values of 6 (20.0%) vs. 1 (3.3%), P = 0.044.</p>Conclusion<p>Smoking may reduce the efficacy of apnoeic oxygenation with high-flow nasal cannula in obese males and diminish effective pulmonary reserve.

Smoking cessation should be recommended, and patients should be advised not to smoke during the peri-procedural period.</p>Trial registration<p>Registered at [ClinicalTrials.gov], [NCT06562660, principal investigator: Chao Chen].</p>

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