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Smoking and Postoperative Pain: A Systematic Review and Meta‐Analysis.

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Title: Smoking and Postoperative Pain: A Systematic Review and Meta‐Analysis.
Authors: Chow, Robert (AUTHOR), Lans, Zachary (AUTHOR), Cohen, Steven P. (AUTHOR), Lin, Hung‐Mo (AUTHOR), Zhao, Julian (AUTHOR), Rajput, Kanishka (AUTHOR)
Source: Pain Practice. Nov2025, Vol. 25 Issue 8, p1-12. 12p.
Subjects: Pain measurement, Risk assessment, Medical information storage & retrieval systems, Surgery, Patients, Smoking, Postoperative pain, Meta-analysis, Descriptive statistics, Systematic reviews, MEDLINE, Surgical complications, Opioid analgesics, Non-smokers, Medical databases, Confidence intervals, Online information services, Drug utilization, Disease risk factors
Abstract: Background: Smoking is known to increase the risk of numerous postoperative complications, including increased rates of infection, cardiovascular events, and pulmonary complications. In addition, there may be an effect of smoking on pain in the perioperative period. Through this meta‐analysis, we sought to investigate what is known about the relationship between smoking and acute postoperative pain. Methods: Articles published between January 2003 and December 2023 that compared smokers to nonsmokers and utilized pain scores and/or measured postoperative opioid consumption were selected for review. 95% confidence intervals were utilized to determine statistical significance in standardized mean differences for each outcome between smokers and nonsmokers. Results: The meta‐analysis included five studies that assessed postoperative pain scores and opioid requirements in smokers and nonsmokers. In the analysis of pain scores, smokers consistently had higher pain scores overall on all postoperative days (POD) 0 (0.46 [95% CI: 0.26–0.66]), POD1 (0.32 [0.17–0.46]), and POD2 (0.38 [0.24–0.52]). Smokers also demonstrated higher opioid requirements compared to nonsmokers on POD0 (0.62 [0.43–0.80]), POD1 (0.49 [0.36–0.62]), and POD2 (0.70 [0.56–0.84]). Four additional studies were included in our systematic review, which further revealed an association between smoking history and postoperative pain. Conclusions: Smokers demonstrate increased postoperative pain, as assessed by pain scores and opioid requirements. The ability to anticipate increased postoperative pain in this population has the potential to improve postoperative outcomes for patients with a smoking history. [ABSTRACT FROM AUTHOR]
Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Smoking and Postoperative Pain: A Systematic Review and Meta‐Analysis.
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  Data: <searchLink fieldCode="AR" term="%22Chow%2C+Robert%22">Chow, Robert</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lans%2C+Zachary%22">Lans, Zachary</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cohen%2C+Steven+P%2E%22">Cohen, Steven P.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lin%2C+Hung‐Mo%22">Lin, Hung‐Mo</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Zhao%2C+Julian%22">Zhao, Julian</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Rajput%2C+Kanishka%22">Rajput, Kanishka</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Pain+Practice%22">Pain Practice</searchLink>. Nov2025, Vol. 25 Issue 8, p1-12. 12p.
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  Data: <searchLink fieldCode="DE" term="%22Pain+measurement%22">Pain measurement</searchLink><br /><searchLink fieldCode="DE" term="%22Risk+assessment%22">Risk assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+information+storage+%26+retrieval+systems%22">Medical information storage & retrieval systems</searchLink><br /><searchLink fieldCode="DE" term="%22Surgery%22">Surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Patients%22">Patients</searchLink><br /><searchLink fieldCode="DE" term="%22Smoking%22">Smoking</searchLink><br /><searchLink fieldCode="DE" term="%22Postoperative+pain%22">Postoperative pain</searchLink><br /><searchLink fieldCode="DE" term="%22Meta-analysis%22">Meta-analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Systematic+reviews%22">Systematic reviews</searchLink><br /><searchLink fieldCode="DE" term="%22MEDLINE%22">MEDLINE</searchLink><br /><searchLink fieldCode="DE" term="%22Surgical+complications%22">Surgical complications</searchLink><br /><searchLink fieldCode="DE" term="%22Opioid+analgesics%22">Opioid analgesics</searchLink><br /><searchLink fieldCode="DE" term="%22Non-smokers%22">Non-smokers</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+databases%22">Medical databases</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Online+information+services%22">Online information services</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+utilization%22">Drug utilization</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+risk+factors%22">Disease risk factors</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Background: Smoking is known to increase the risk of numerous postoperative complications, including increased rates of infection, cardiovascular events, and pulmonary complications. In addition, there may be an effect of smoking on pain in the perioperative period. Through this meta‐analysis, we sought to investigate what is known about the relationship between smoking and acute postoperative pain. Methods: Articles published between January 2003 and December 2023 that compared smokers to nonsmokers and utilized pain scores and/or measured postoperative opioid consumption were selected for review. 95% confidence intervals were utilized to determine statistical significance in standardized mean differences for each outcome between smokers and nonsmokers. Results: The meta‐analysis included five studies that assessed postoperative pain scores and opioid requirements in smokers and nonsmokers. In the analysis of pain scores, smokers consistently had higher pain scores overall on all postoperative days (POD) 0 (0.46 [95% CI: 0.26–0.66]), POD1 (0.32 [0.17–0.46]), and POD2 (0.38 [0.24–0.52]). Smokers also demonstrated higher opioid requirements compared to nonsmokers on POD0 (0.62 [0.43–0.80]), POD1 (0.49 [0.36–0.62]), and POD2 (0.70 [0.56–0.84]). Four additional studies were included in our systematic review, which further revealed an association between smoking history and postoperative pain. Conclusions: Smokers demonstrate increased postoperative pain, as assessed by pain scores and opioid requirements. The ability to anticipate increased postoperative pain in this population has the potential to improve postoperative outcomes for patients with a smoking history. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Pain Practice is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=189263591
RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1111/papr.70083
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      – Code: eng
        Text: English
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        PageCount: 12
        StartPage: 1
    Subjects:
      – SubjectFull: Pain measurement
        Type: general
      – SubjectFull: Risk assessment
        Type: general
      – SubjectFull: Medical information storage & retrieval systems
        Type: general
      – SubjectFull: Surgery
        Type: general
      – SubjectFull: Patients
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      – SubjectFull: Smoking
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      – SubjectFull: Postoperative pain
        Type: general
      – SubjectFull: Meta-analysis
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Surgical complications
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      – SubjectFull: Opioid analgesics
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      – SubjectFull: Non-smokers
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      – SubjectFull: Drug utilization
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      – SubjectFull: Disease risk factors
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      – TitleFull: Smoking and Postoperative Pain: A Systematic Review and Meta‐Analysis.
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              M: 11
              Text: Nov2025
              Type: published
              Y: 2025
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