According to new recommendations, anesthesiologists should inquire about cannabis usage from patients before they have surgery, especially if they use it frequently. Dr. Samer Narouze, president of the American Society of Regional Anesthesia and Pain Medicine, stated that cannabis use, particularly when it is frequent and heavy, can cause patients to experience greater pain than usual after surgery and that using marijuana right before surgery can increase a patient’s risk for heart problems, including a heart attack.
The recommendations, which the society announced on Jan. 3, are meant to be both instructional and educational, according to Narouze. Even while medical schools are now beginning to teach about cannabis, the majority of already practicing physicians found that their training did not teach them much about the drug or how the body responds to it.
“For every anesthesiologist in practice, it is an issue. They have this patient, but they’re at a loss for what to do “Narouze, who is also the director of the Western Reserve Hospital’s Center for Pain Medicine in Cuyahoga Falls, Ohio, stated. According to the guidelines, anesthesiologists should inquire about their patients’ cannabis use, including how much, how frequently, and how recently they used it.
They should also find out if they smoked or consumed their cannabis. The recommendations include delaying elective surgery if a patient shows up impaired and warning expectant mothers about the dangers of marijuana use to their unborn child.
Some heavy marijuana users could need more anesthetic to put them to sleep or keep them sleeping, he said. Acute cannabis intoxication can cause confusion, a racing heart, panic attacks, and the inability to give informed consent for surgery, according to Narouze. Heavy use may make patients more irritable while recovering.
According to Narouze, a brief discussion prior to surgery can assist the anesthesiologist in providing adequate pain management and assist the patient in understanding their risks. When recovering, a heavy user may require greater supervision, and their release may be postponed. He explained that an anesthesiologist can effectively manage the patient if they are aware of the hazards.
Marijuana Use Can Leave Patients in More Pain than Normal After Surgery
According to Dr. Peter Yeh, an anesthesiologist at the University of California, San Francisco, anesthesiologists always takes into account “multi-modal” techniques for pain treatment to reduce side effects. However, as a regular, heavy marijuana user, he pays close attention to other pharmaceutical categories, such as nerve blocks or epidural.
THC, a component of cannabis, can relieve pain in modest dosages but can worsen it in large ones, according to Narouze. The same applies to nausea. Patients with hyperemesis, or basically continual vomiting, brought on by heavy cannabis usage are becoming more common in emergency rooms.
Because edibles take longer to provide a high, people may believe they haven’t consumed enough food, increasing the risk for hyperemesis, according to Narouze. Smoking produces a quick high that also wears off quickly, but edibles take longer to take effect and have a longer-lasting impact.
A heavy cannabis user may also skip one or two scheduled dosages during a protracted operation and recovery, increasing agony, according to Narouze. According to the National Conference of State Legislatures, cannabis use for medical purposes is permitted in 37 states, while recreational use is permitted in 19 states and the District of Columbia.
Yeh claimed that since his patients are counseled about cannabis usage before surgery, he has never had a surgical patient who is intoxicated. However, he considers a patient’s marijuana use when deciding how to do surgery and recuperate from it. It is unquestionably dose-dependent, he said. It’s just something we have to think about when taking care of you, I guess.
