What doctors are learning about marijuana and surgery

 

People who use cannabis may need more anesthesia during procedures, but many are wary of mentioning their habit.

The marijuana habit has a surprising side effect that many people don't know: Regular users may need more anesthesia during medical procedures to stay sedated.

As more states allow people to legally smoke pot and eat edibles, more doctors say they're asking about marijuana use before surgery or procedures and urging honesty because the habit Users may need more anesthesia and painkillers. In one study, people who reported that they used cannabis required more anesthesia than people who did not use it.

"Disclosing your cannabis use to your anesthesiologist is incredibly important," says Stacy Gruber, director of the Marijuana Investigations for Neuroscientific Discovery (MIND) program at McLean Hospital in Belmont, Mass., who led a recent study in the journal Frontiers. Co-authored the study. Looking at interactions between cannabis and other drugs in psychiatry.

Doctors say hospitals already ask about alcohol consumption, which can also affect your anesthesia requirements. Many people don't readily mention marijuana use, and health workers in some states don't routinely ask.

A 2021 federal survey found that 18.7% of people age 12 or older had used marijuana in the past year.

It is unclear whether complications of anesthesia are largely limited to those who use THC, the main psychoactive component of marijuana that causes the high, or extend to those who use cannabidiol or CBD. Let's take The latter does not produce a high like THC and is sometimes used as a remedy for pain, sleep, or anxiety. Many cannabis products, such as edibles, contain a combination of the two.

Julius Hyatt, an oral surgeon at the University of Maryland Center for Oral Surgery and Dental Implants in Cockeysville, MD, began noticing a few years ago that more of his patients were requiring larger amounts of anesthesia to remain sedated.

They say that some patients who regularly used cannabis required two to three times the usual amount of the anesthetic propofol to stay down. He and others in his practice sometimes had to start adding other drugs used in sedation, such as fentanyl and ketamine, to maintain sedation for patients who were undergoing oral surgery. Was getting restless during. Doctor. Hyatt's practice changed the form of its health history to ask more specific questions about patients' marijuana use.

However, doctors say you don't need to worry about being awake during the procedure. Anesthesiologists monitor the level of sedation and may give more if they see signs that the drugs are wearing off. But regular marijuana users need more anesthesia to get sedated and stay that way.

In January, the American Society of Regional Anesthesia and Pain Medicine published guidelines recommending that all patients undergoing anesthesia for an inpatient or outpatient procedure be screened and questioned about cannabis use. including how much and how often, how they take it, and when they take it. He used it last.