E-cigarettes Users: Anesthesia Revisited
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Abstract
E-cigarettes, also known as electronic nicotine delivery systems, have gained widespread popularity as an alternative to combustible tobacco. While often perceived as safer, emerging evidence demonstrates significant respiratory, cardiovascular, and systemic effects relevant to anesthesia. These include airway inflammation, bronchial hyperreactivity, cardiovascular stimulation, and an association with acute lung injury known as E-cigarette or vaping-associated lung injury (EVALI). For anesthetic personnel, E-cigarette use introduces unique perioperative challenges, particularly in airway management, ventilation strategies, hemodynamic stability, and postoperative recovery. This review summarizes current evidence on the physiological impact of E-cigarette use, outlines anesthetic considerations across the perioperative continuum, and provides a practical summary table to guide clinical decision-making
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