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i am getting ready for neck spinal surgery,what is a safe nicotine level for the surgery,i have quit and 2.0 is my level right now

By Anonymous April 13, 2009 - 6:41am
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Just wondering what a safe level is for neck surgery. I am getting ready to have spinal surgery on my neck and i have been on chantix and have come real close to not smoking for 30 days(a few slips) am at a 2.0 level of nicotine in my blood, is that low enough to have my surgery done?

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Dear Anon,

First of all, let me congratulate you for quitting smoking!! That's a huge battle that you've just about won. And you've done more for your health by quitting smoking than almost anything else you could do. I hope you are patting yourself on the back, because you deserve it. You are lowering your risk of many diseases, including cancer and heart disease, and I'm sure that you are feeling better just in 30 days. (Even with a few slips!)

I am sure that your primary doctor knows your nicotine levels, since Chantix is by prescription. Does your surgeon know that you are on Chantix? Has she or he given you any indication of the level that is best? (Your anesthesiologist will also visit you before the surgery and it's very important to tell him or her as well).

From what I read, I would expect that your doctors will take you off the Chantix perhaps the day of or day before the surgery. This will also lower the nicotine level in your blood. Nicotine itself has a short shelf life in your blood and works its way out of your system in just a few hours. Has your doctor talked about this?

Part of the key to nicotine levels is, of course, how many cigarettes a person smokes in a day, and how their body metabolizes the nicotine. (That means that from person to person, a cigarette may have slightly different levels of effectiveness). Just as a matter of comparison, one research study studied habitual smokers with no psychiatric disorders who consumed 26 or more cigarettes per day. They had blood nicotine levels of 20.0–68.0 ng/ml. There's quite a contrast between those levels and the 2.0 level you currently have.

As far as the surgery goes, among the concerns are whether a smoker has reduced oxygen intake due to carbon monoxide in the system, whether their blood pressure and/or heart rate is higher than usual, and whether their liver is functioning at its best. Smokers can have more difficulty emerging from anesthesia and an increase in some things like bronchospasm or pneumonia. They also can be slower to heal their surgical wounds and more prone to infection.

Here's a great page quoting the Mayo Clinic on quitting before surgery. It says you've already dropped your risks significantly:


Here is something from anesthesiology.info about quitting smoking before surgery:

"The good news is that patients who quit for more than four weeks do seem to have a decreased risk of complications. In addition, patients who are able to quit for ten weeks or more have their risk reduced to almost the same as patients that have never smoked. Smoking cessation is not futile - and should be encouraged in patients that have surgery and anesthesia scheduled more than a month in advance. The data is encouraging in that patients that indeed quit can reduce their risk to close to nonsmokers in as little as ten weeks. The motivation to decrease their risk for anesthesia may be the motivator that some patients need to quit for good. This is a positive step to take, not just for anesthesia, but for overall health and well-being."

That's from this page:


Here is what another paper says about quitting smoking before surgery. It also talks about time instead of exact nicotine levels, however:

"While some adverse effects can improve following 24 hours of abstinence, like effects of carboxyhemoglobin and nicotine effect on heart rate and blood pressure, others thers like increased blood viscosity and risk of postoperative deep venous thrombosis takes few days to reverse. The effect on the small airways and sputum production declines over a 6-week period of abstinence while 6 months of preoperative abstinence will reduce the incidence of postoperative chest infection to that of non-smokers after cardiac surgery."

That comes from this article:


And one more you may be interested in:


Does all this help somewhat?

Is your surgery very soon? Or do you have more time to continue to wean your levels down?

April 13, 2009 - 8:47am
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