How cannabis can impact anesthesia and surgery

Cannabis has a lot of health benefits, including reducing chronic pain and insomnia, as well as making it easier to cope with anxiety, sadness, and post-traumatic stress disorder (PTSD) and find peace and enjoyment in life. However, cannabis does not always combine well with other medicines, and depending on the drug, it might be downright hazardous. When it comes to cannabis and anesthesia, this is undoubtedly the case.

Preparing for surgery can be stressful for a variety of reasons, so we’ll discuss the necessity of sharing your cannabis routine with your anesthesia provider, as well as the effects of various cannabis ingestion techniques on anesthesia, so you can lower your risk of issues.

Be honest about your cannabis routine

If you live in a cannabis prohibition state, or even a state where cannabis has been allowed for medical use only, you might be wondering if it’s legal to discuss your cannabis habits with your anesthetic provider.

Conversations between you and your physician, nurses, and other healthcare workers, as well as information added to your medical record by healthcare providers, are considered protected health information under the HIPAA Privacy Law.

Healthcare providers are only allowed to share your protected health information with law enforcement officials in a very limited instances, such as when an individual’s or the public’s safety is in jeopardy, or to comply with a court order.

Dr. Daniel King, CRNA, and member of the American Association of Nurse Anesthetists, said, “The only break in that agreement comes with the legal and ethical responsibility to report circumstances that have the potential for significant bodily injury to oneself or others” (AANA). “In my practice, we strive to fully comprehend our patients’ medical histories in order to provide them with beneficial outcomes.”

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In fact, it’s critical to inform your anesthesia physician about your habits because cannabis has affects on the cardiovascular and respiratory systems that could put you at risk while you’re under anesthesia.

“These hazards include vocal cord spasms or lung small airway spasms,” King said. “Cross-tolerance to routinely used anesthetic medications is also a risk, and cannabis users may require greater doses and/or the use of other agents.”

Provide information on the type of cannabinoid consumed (THC, CBD, etc. ), any periods of abstinence from the product, patterns of use, such as dose, method, frequency, and length of use, and whether it is being used for medical purposes when speaking with your anesthesia provider about your cannabis routine.

How CBD and THC products impact anesthesia differently

The effects of THC and CBD on anesthesia are vastly different. The effects of the two on the cardiovascular and gastrointestinal systems, in particular, are almost diametrically opposed.

“THC is more likely to cause fast heart rhythms and high blood pressure, whereas CBD lowers blood pressure and slows the heart rate,” King explained. “THC stimulates hunger in the gastrointestinal system, but it has also been associated to reduced stomach motility with long-term usage, which may raise the likelihood of adverse outcomes including aspiration pneumonia.”

“Tolerance to THC tends to develop very quickly—meaning the patient may become dosage tolerant after only a few doses and require higher doses to obtain the same effects,” he explained.

This new chemical found in CBD products may aid in sleep, anxiety, and concentration.

He went on to note that THC is broken down in the body by a cellular process that is similar to that of conventional anesthetic medicines, raising concerns that a high THC tolerance may necessitate higher anaesthetic drug doses.

“At this time, we do not have the degree of researched evidence available to be able to make formal recommendations for usage of one or the other in either the pre-operative or post-operative period,” King said.

This scientific review, for example, lists several studies that show cannabis users have higher pain scores and a greater requirement for pain-relieving drugs after surgery. There is a clear need for more research on how THC interacts with anesthetic medicines.

How different methods of cannabis consumption can impact anesthesia

Patients frequently require procedures such as intubation and artificial ventilation during surgery, thus anesthesia providers are well-versed in airway anatomy and physiology. As a result, managing the respiratory system when smoking or vaping cannabis is a major problem.

Patients who smoke or vape may experience more symptoms including coughing, wheezing, or spasms of the vocal cords and small airways, according to King. “Because marijuana burns at a greater temperature than cigarettes, it has the potential to damage the linings of airway airways and even scar lung tissue over time. When opposed to oral intake, all of these make respiratory management more important if the patient smokes or vapes products.”

Is cannabis a habit-forming substance?

For pre-op and post-op consumption, King offers the following guidelines: “Avoid smoking for at least 24 hours before surgery to reduce airway sensitivity and enhance wound healing, but ideally for as long as possible.”

Patients should also wait until the effects of their anesthetics and pain drugs have worn off entirely before resuming cannabis use.

Furthermore, according to King, combining cannabis with opiates or alcohol might result in diminished reflexes and greater drowsiness, as well as compromising memory and cognitive function.

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