• Robert A Drongowski, Donald Lee, Paul I Reynolds, Shobha Malviya, Carroll M Harmon, James Geiger, Joseph L Lelli, and Arnold G Coran.
• University of Michigan, Department of Surgery, Mott Children's Hospital, Ann Arbor, MI 48109-0245, USA. bobd@umich.edu
• Paediatr Anaesth. 2003 May 1; 13 (4): 304-10.

ObjectiveThe aim of this study was to determine if children exposed to environmental tobacco smoke (ETS) via parental smoking (ETS+) developed more respiratory symptoms resulting in longer recovery times following surgical outpatient procedures compared with children of nonsmoking parents (ETS-).MethodsOne hundred and forty six children (4.9 +/- 3 years) undergoing inguinal hernia repair were prospectively studied. Parental smoking behaviour was determined by survey and urine analysis. Seven respiratory symptoms were evaluated during induction and emergence from anaesthesia and during the recovery room (RR) stay.ResultsFifty-seven (39%) families admitted a smoking history while 89 (61%) denied it. This strongly correlated with the cotinine/creatinine ratio (Pearson correlation coefficient = 0.76; P = 0.01). ETS exposure was associated with an increased frequency of RR symptoms (ETS+: 56%; ETS-: 31%; P = 0.007).ConclusionsIn children undergoing general anaesthesia for inguinal hernia repair, ETS exposure was associated with an increased frequency of respiratory symptoms during emergence from anaesthesia and during postoperative recovery.

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