“Determining cannabis use before procedural sedation can be an important tool for planning patient care,” says the study published in the Journal of the American Osteopathic Association
Regular cannabis users may require up to twice as much anesthesia when undergoing medical procedures, according to a new preliminary study from researchers in Colorado published in the Journal of the American Osteopathic Association.
Researchers studied the medical records of patients who underwent endoscopic procedures (nonsurgical procedures performed with an endoscope to examine the digestive tract). Of the 250 patients surveyed, cannabis users required 20% more midazolam, 220% more propofol and 14% more fentanyl to realize the optimum level of sedation for the duration of the procedure. The mechanism of the interaction is “unknown,” says the study.
The records were collected from patients with the same endoscopist, at the same clinic in Colorado to minimize variables. The state legalized medical cannabis in 2000 and recreational cannabis in 2014, rendering it a state in which patients are less reluctant to report their consumption.
“Because cannabis is considered a Schedule I drug by the US Drug Enforcement Agency, research has been almost absent regarding its interaction with medications and its effects on patient response to medications. Gaining information on these issues has been further complicated by the hesitance of patients to report use of an illegal substance,” wrote lead author Mark Twardowski, DO, an osteopathic internal medicine physician, although he also notes that the related stigma may still deter some users from reporting their consumption.
Twardowski also stresses the need for more research.
“With little research currently done in this area and the continued increase in legalization and use of cannabis, the field of anesthesia and sedation needs further studies with greater depth,” he writes.
“Determining cannabis use before procedural sedation can be an important tool for planning patient care and assessing both medication needs and possible risks related to increased dosage requirements during endoscopic procedures,” concludes the study.
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