Consumption of Oral Nicotine Products in Relation to Postanesthesia Care Unit Recovery After Laparoscopic Appendectomy. A Prospective Study.

Nurkkala, Juho; Lampela, Hanna; Sammalkorpi, Henna; Liisanantti, Janne; Kontinen, Vesa; Schramko, Alexey · Acta Anaesthesiol Scand · 2026

prospective_cohort · Level II

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Abstract

Oral nicotine product (ONP) consumption is constantly increasing while combustible cigar smoking is becoming rare. Possible effects of ONP consumption for early recovery after general anesthesia are poorly recorded. Prospective single-center study with 151 participants undergoing laparoscopic appendectomy. Incidence of ONP consumption was recorded and consumers were compared to non-consumers intraoperatively and during postanesthesia care unit (PACU) stay. Of 151 patients 32 (21%, 95% CI, 15%-28%) reported regular ONP consumption and it was associated with elevated pain scores (NRS > 3) in PACU (2.30 (1.03-5.13), p = 0.04) whereas the association with postoperative nausea and vomiting occurrence (0.91 (0.34-2.47), p = 0.86) or prolonged PACU duration (1.08 (0.39-2.94), p = 0.89) was not found. Based on this study, ONP consumption was associated with higher pain scores. In this study, postlaparscopic appendectomy pain scoring was recorded in a cohort who also reported their habits for oral nicotine product use. In this cohort in Finland, there was an association observed between oral nicotine product use and higher reported pain scores, a larger percentage of cases with NRS scoring over 3.

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