Table 1

Characteristics of 15 studies focusing on anaesthetic and recovery outcomes

Study authorYearOutcome methodologyAge group (identified/included)Surgical groupLocationETS measure (number exposed)ETS priorityOutcomesQuality score
Drongowski142003Prospective cohort3 months–13 years (n=146/146)Inguinal hernia repairUSAParent questionnaire on smoking history/exposure and urinary cotinine (57 ETS+)Observed respiratory events in induction, emergence and recovery8
Jones152006Prospective cohort1–18 years (n=428/405)Elective day case: mixed specialtiesUSAParent completed risk factor questionnaire, included smoking history (168 ETS+)Airway complications observed against graded scale intraoperatively and post anaesthesia7
Kim162013Retrospective cohortChild: not defined (n=159/159)Had URI symptom;
ENT and ophthalmology
South KoreaPassive smoking documented in anaesthetic record (28 ETS+)Respiratory adverse events documented in notes at intubation, intra-extubation and post-extubation, and in recovery7
Lakshmipathy171996Retrospective cohortChild: not defined (n=322/310)Elective day case: ENT and urologyUSAParent reported regular smoker at home (96 ETS+)Laryngospasm documented in records7
Lyons181996Prospective cohort1–12 years (n=?/125)Elective day case: not ENTIrelandParental questionnaire of home and other smoker contacts (63 ETS+)Respiratory adverse events observed by blinded anaesthetist at preoperative, intraoperative and postoperative points6
Mamie192004Prospective cohort1–14 years (n=800/743)Mixed specialtiesSwitzerlandParent completed allergy/ asthma questionnaire, including smoking (429 ETS+)Intraoperative, postoperative and perioperative respiratory adverse events7
O'Rourke202006Prospective matched cohort5–15 years (n=93 at recovery; 96 at discharge)Convenience sample; non-cavity surgeryUSADirect parental questioning (46 ETS+ at recovery, 49 ETS+ at discharge)Pulmonary function as percentage predicted; respiratory events secondary outcome7
Parnis412011Prospective case–controlChild: not defined* (n=?/2051)Mixed specialtiesAustraliaParental smoking status as part of wider research questionnaire (926 ETS+)‘Good’ vs ‘bad’ anaesthetic outcome, including adverse respiratory, gastrointestinal and circulatory events6
Reisli212004Prospective cohort4–10 years (n=40/40)ENT surgery; convenience sampleTurkeyParental questioning of child's overall ETS exposure (20 ETS+)Rocuronium dose required for neuromuscular blockade6
Seyidov222011Prospective cohort3 months–12 years (n=402†/385)Elective surgeryTurkeyParent questioning of quantity of smoke exposure (234 ETS+)Respiratory adverse events observed by blinded team7
Skolnick231998Prospective cohort1 month–12 years (n=602/499)Elective surgeryUSAUrinary cotinine and parental enquiry (262 ETS+)Respiratory adverse events8
Tait242001Prospective cohort1 month–18 years (n=1078/407)Elective surgery with active URIUSAQuestionnaire including parental smoking habitsContribution of factor to overall predictive multiple regression model6
Thikkurissy252012Prospective cohort19 months–12 years (n=?/99)DentalUSAParental interview on smoking status and quantity (51 ETS+)Respiratory adverse events observed by blinded anaesthetist and recovery nurse7
Tütüncü262011Prospective cohort1–15 years (n=?/150)Convenience sample; lower abdominal/urologyTurkeyParental questionnaire including parent smoking status (100 ETS+)Secondary outcome of postoperative respiratory complications5
von Ungern-Sternberg et al272010Prospective cohortChild: not defined (n=10496/9038)Anaesthesia for elective and urgentAustraliaParent smoking report at preoperation check (2929 ETS+)Perioperative adverse events8
  • *Study age range from 0 to 22 years. Mean age 5.8. Reviewers made decision to include in study.

  • †There is an apparent numerical error in the original paper where the identified total appears not to include exclusions.

  • ENT, ear, nose and throat; ETS, environmental tobacco smoke; URI, upper respiratory infection.