• Daniela Pereira, Andreia Dos Santos Borrego, and Ângela Garcia Alves.
• Hospital de Santa Maria. Centro Hospitalar Universitário Lisboa Norte. Lisboa. Portugal.
• Acta Medica Port. 2022 Sep 1; 35 (9): 663-668.

IntroductionThe implementation of policies aimed at promoting smoking cessation led to a decrease in the use of tobacco. There has been an increase in the use of systems such as electronic nicotine delivery systems and electronic non-nicotine delivery systems - also known as electronic cigarettes, and heat-not-burn tobacco products. The aim of this review is to describe the pathophysiological implications of these devices and their perioperative impact.Material And MethodsA literature search was carried out by the authors to identify studies published in English on PubMed and MEDLINE between 2007 and 2021, and using the terms 'vaping', 'electronic nicotine delivery systems', 'heated tobacco products', 'IQOS' and 'anesthesia'. A total of 654 articles were found, and the most relevant ones were selected.ResultsThere is currently insufficient information available regarding the perioperative implications of electronic cigarettes and heat not-burn tobacco products. These devices release potentially harmful substances - such as nicotine - that have a negative impact on the health of consumers. These substances affect the cardiovascular, respiratory and immune systems, and can interact with multiple drugs, which can affect the anesthetic management. The users of these devices are also at a higher risk of explosion injuries and cancer. A number of interventions that may improve the perioperative management of these patients are suggested.ConclusionAwareness of the potential harmful effects of these devices, and their perioperative implications, is essential, as it enables the implementation of interventions to minimize the risks and improve patient outcomes.

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