Hostname: page-component-84b7d79bbc-g78kv Total loading time: 0 Render date: 2024-07-30T12:55:58.719Z Has data issue: false hasContentIssue false

Case Report: Nicotine Replacement Therapy (NRT) in Hospitalized Surgical Patient

Published online by Cambridge University Press:  03 March 2015

Laurel Sisler
Affiliation:
Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, 27599
Susan Trout
Affiliation:
Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, 27599
Carol Ripley-Moffitt
Affiliation:
Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, 27599
Adam O. Goldstein
Affiliation:
Department of Family Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, 27599

Extract

Hospital surgical services are often reluctant to offer nicotine replacement therapy (NRT) to inpatients due to concerns that nicotine leads to vasoconstriction and impaired wound healing. However, multiple potential health benefits result from offering NRT to hospitalized surgical patients who use tobacco products. A 28-year-old female patient, hospitalized following a motor vehicle accident, experienced severe nicotine withdrawal symptoms and a strong desire to smoke. After a Tobacco Treatment Specialist (TTS) consultation, the Physical Medical and Rehabilitation service at the hospital began her on NRT with positive outcomes. The patient experienced decreased cravings and withdrawal symptoms, as well as an increased desire to remain tobacco free after discharge. More surgical patients may have an increased commitment to remain tobacco free after discharge, if their withdrawal symptoms are treated during hospitalization using NRT.

Type
Case Report
Copyright
Copyright © The Author(s) 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Black, C. E., Huang, N., Neligan, P. C., Levine, R. H., Lipa, J. E., & Lintlop, S.et al. (2001). Effect of nicotine on vasoconstrictor and vasodilator responses in human skin vasculature. American Journal of Physiology - Regulatory, Integrative and Comparative Physiology, 281 (4), R1097R1104. Retrieved from http://ajpregu.physiology.org/content/281/4/R1097.Google Scholar
Carandang, R. A., Barton, B., Rordorf, G. A., Ogilvy, C. S., & Sims, J. R. (2011). Nicotine replacement therapy after subarachnoid hemorrhage is not associated with increased vasospasm. Stroke, 42 (11), 30803086. Retrieved from http://stroke.ahajournals.org/content/42/11/3080.short.Google Scholar
Fiore, M. C., Jaen, C. R., Baker, T. B., Bailey, W. C., Bennett, G., Benowitz, N. L., . . . Dorfman, S. F. A. (2008). A clinical practice guideline for treating tobacco use and dependence: 2008 update. A US Public Health Service report. Am J Prev Med, 35 (2), 158–76. Retrieved from http://www.ncbi.nlm.nih.gov/m/pubmed/18617085/.Google Scholar
Forrest, C. R., Xu, N., & Pang, C. Y. (1994). Evidence for nicotine-induced skin flap ischemic necrosis in the pig. Canadian Journal of Physiology and Pharmacology, 72 (1), 3038. doi:10.1139/y94-006.Google Scholar
Hughes, J. R. (2007). Effects of abstinence from tobacco: valid symptoms and time course. Nicotine & Tobacco Research, 9 (3), 315327. Retrieved from http://ntr.oxfordjournals.org/content/9/3/315.short.Google Scholar
Møller, A. M., Villebro, N., Pedersen, T., & Tønnesen, H. (2002). Effect of preoperative smoking intervention on postoperative complications: A randomised clinical trial. The Lancet, 359 (9301), 114117. Retrieved from http://www.sciencedirect.com/science/article/pii/S0140673602073695.Google Scholar
Molyneux, A., Lewis, S., Leivers, U., Anderton, A., Antoniak, M., Brackenridge, A., . . . others. (2003). Clinical trial comparing nicotine replacement therapy (NRT) plus brief counselling, brief counselling alone, and minimal intervention on smoking cessation in hospital inpatients. Thorax, 58 (6), 484488. Retrieved from http://thorax.bmj.com/content/58/6/484.short.Google Scholar
Reid, R. D., Mullen, K.-A., D’Angelo, M. E. S., Aitken, D. A., Papadakis, S., & Haley, P.M.et al. (2010). Smoking cessation for hospitalized smokers: An evaluation of the “Ottawa Model.” Nicotine & Tobacco Research, 12 (1), 1118. Retrieved from http://ntr.oxfordjournals.org/content/12/1/11.short.Google Scholar
Rigotti, N. A., Munafo, M. R., & Stead, L. F. (2007). Interventions for smoking cessation in hospitalised patients. Cochrane Database of Systematic Reviews, 3, 152. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD001837.pub2/pdf/standard.Google Scholar
Seder, D. B., Schmidt, J. M., Badjatia, N., Fernandez, L., Rincon, F., & Claassen, J.et al. (2011). Transdermal nicotine replacement therapy in cigarette smokers with acute subarachnoid hemorrhage. Neurocritical Care, 14 (1), 7783. Retrieved from http://link.springer.com/article/10.1007/s12028-010-9456-9.Google Scholar
Sørensen, L. T. (2012). Wound healing and infection in surgery: The pathophysiological impact of smoking, smoking cessation, and nicotine replacement therapy: a systematic review. Annals of Surgery, 255 (6), 10691079. Retrieved from http://journals.lww.com/annalsofsurgery/Abstract/2012/06000/Wound_Healing_and_Infection_in_Surgery___The.10.aspx.Google Scholar
Sorensen, L. T., Karlsmark, T., & Gottrup, F. (2003). Abstinence from smoking reduces incisional wound infection. Annals of Surgery, 238 (1), 15. doi:10.1097/01.SLA.0000074980.39700.31.Google Scholar
Stead, L. F., Perera, R., Bullen, C., Mant, D., Hartmann-Boyce, J., Cahill, K., & Lancaster, T. (2012). Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev, 11 (11). Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000146.pub4/pdf/standard.Google Scholar