SynthesisArchives of disease in childhood2017
Impact of environmental tobacco smoke exposure on anaesthetic and surgical outcomes in children: a systematic review and meta-analysis.
Synthesis in Archives of disease in childhood, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.
- Family and carer smoking control programmes for reducing children's exposure to environmental tobacco smoke.The Cochrane database of systematic reviews · 2018Pooled it
- Secondhand smoke exposure and human health: an umbrella review.Nature human behaviour · 2026Article
- Impact of a brief peri-operative counselling session on parental awareness of passive smoking in paediatric ambulatory surgery: A single-centre observational study.European journal of anaesthesiology and intensive care · 2026Article
- Impact of Passive Smoking on Vital Signs, Motor Activity, and Agitation in Children Undergoing Dental Extractions Under Sedation: A Short-Term Cohort Study.Healthcare (Basel, Switzerland) · 2026Article
- Social Drivers of Health in Pediatric Perioperative Care.Anesthesiology · 2026Review
- Effect of passive tobacco smoke on the incidence of respiratory adverse events in female patients undergoing general anesthesia- a cohort study.BMC anesthesiology · 2025Article
- Protecting our future: environmental hazards and children's health in the face of environmental threats: a comprehensive overview.Clinical and experimental pediatrics · 2024Article
- Analysis of factors that influence the occurrence of otitis media with effusion in pediatric patients with adenoid hypertrophy.Frontiers in pediatrics · 2023Article
- A practical guide for perioperative smoking cessation.Journal of anesthesia · 2022Review
- The effect of passive smoking on the laryngospasm rate in children sedated during the esophagogastroduodenoscopy.Saudi medical journal · 2022Observational
- Article
- Malaysian adolescents' exposure to secondhand smoke in the car of their parents/guardians: A nationwide cross-sectional school-based study.Tobacco induced diseases · 2020Article
- Rates of exposure to environmental tobacco smoke from various indoor environments among US children and nonsmoker adolescents and adults.Environmental science and pollution research international · 2018Article
- Perioperative respiratory complications: current evidence and strategy discussed in 2017 JA symposium.Journal of anesthesia · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundTobacco smoke exposure in adults is linked to adverse anaesthetic and surgical outcomes. Environmental tobacco smoke (ETS) exposure, including passive smoking, causes a number of known harms in children, but there is no established evidence review on its impact on intraoperative and postoperative outcomes.
objectivesTo undertake a systematic review of the impact of ETS on the paediatric surgical pathway and to establish if there is evidence of anaesthetic, intraoperative and postoperative harm. ELIGIBILITY CRITERIA
participantsChildren aged 0-18 years undergoing anaesthetic or surgical procedures, any country, English language papers. EXPOSURE: ETS exposure assessed via questioning, observation or biological marker. OUTCOME MEASURES: Frequency of respiratory and other adverse events during anaesthesia, surgery and recovery, and longer term surgical outcomes.
results28 relevant studies were identified; 15 considered anaesthetic outcomes, 12 surgical outcomes, and 1 a secondary outcome. There was sufficient evidence to demonstrate that environmental smoke exposure significantly increased risk of perianaesthetic respiratory adverse events (Pooled risk ratio 2.52 CI 95% 1.68 to 3.77), and some evidence that ear and sinus surgery outcomes were poorer for children exposed to ETS.
conclusionsETS exposure increases the risk of anaesthetic complications and some negative surgical outcomes in children, and this should be considered when planning surgery. Research is required to demonstrate whether changes in household smoking behaviour prior to surgery reduces risk of adverse outcomes, and to close the evidence gap around other outcomes such as wound healing and respiratory infections. TRIAL REGISTRATION NUMBER: Review registration number 42014014557.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.