The aim of this study was to measure the effect of smoking on bronchial mucus transport velocity with bronchoscope under total intravenous anesthesia.

Twenty six ASA physical status I male patients (13 smokers and 13 nonsmokers) were enrolled into this study. They scheduled to undergo elective orthopedic surgery and were operated under total intravenous anesthesia using propofol and remifentanil. Single drop (approximately 0.02 cc) of methylene blue was applied to the posterior mucosal surface of right main bronchus 5 cm away from carina by the bronchoscope with epidural catheter 30 minutes after tracheal intubation. Two, four minutes after methylene blue application, the transport of methylene blue was observed. Six minutes after methylene blue application, the distance of methylene blue movement was measured.

Mean bronchial mucus transport distance and velocity of methylene blue in smoker group vs nonsmoker group was 9.1 ± 5.5 mm and 1.5 ± 1.0 mm/min vs 24.3 ± 15.2 mm and 4.1 ± 2.5 mm/min respectively. Mean bronchial mucus transport distance of methylene blue in the smoker group was shorter than that in the nonsmoker group (P value < 0.05). Mean bronchial mucus transport velocity of methylene blue in the smoker group was slower than that in the nonsmoker group (P < 0.05).

Smoking may delay transport of bronchial secretion in terms of bronchial mucus transport velocity under total intravenous anesthesia.