Using Marijuana and Having Surgery? Tell Your Anesthesiologist

If you’re using marijuana and have surgery scheduled, take heed. In Colorado, where medical marijuana was legalized in 2000 and recreational use in 2012, medical personnel are discovering that weed may complicate the surgical process.

The concern, according to an article in Kaiser Health News, is that marijuana use may “affect patients’ responses to anesthesia on the operating table” and “either help or hinder their symptoms afterward in the recovery room.”

A small study of Colorado patients found marijuana users required more than triple the amount of the sedative propofol than nonusers. Propofol is the most commonly used parenteral anesthetic in the U.S. for minor and outpatient surgical procedures. The study raises a concern about the increased risks of using larger doses to sedate marijuana users during surgery.

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The Kaiser Health News story reports that these concerns aren’t limited to Colorado — 33 states and the District of Columbia have legalized marijuana use in some form. The American Association of Nurse Anesthetists’ updated clinical guidelines provide information on the potential anesthesia risks that marijuana users may face. In addition to enhancing the effect of medications that cause respiratory or cardiac depression, the guidelines caution about a “profound response to inhaled anesthetics” and a potentially harmful interaction with “nondepolarizing” muscle relaxant medications.

How much and how strong?

Marijuana’s potency varies, and so does its method of consumption — it can be smoked, eaten, or dropped under the tongue. So, even when a medical professional knows a patient is using pot, it’s difficult to judge how it’s affected their body. Unlike traditional medications, there is no standard dose for treating someone with medical marijuana. There’s also no government-supervised quality control. As Dr. Joy Hawkins, a professor of anesthesiology at the University of Colorado School of Medicine, tells Kaiser: “For marijuana, it’s a bit of the Wild West. We just don’t know what’s in these products that they’re using.”

Be candid about your marijuana use

It may be difficult for a patient to be upfront with a medical professional about their marijuana use, whether medical or recreational. Though some physicians see medical marijuana as a legitimate part of a treatment regimen for an illness such as multiple sclerosis, others are not as open-minded. Being honest about it may be especially difficult if you live in a location where marijuana use hasn’t been legalized in any form. But based upon the information in the above story, if you’re planning to have a surgical procedure, it seems to me that it’s in your best interests to disclose your pot use to those involved in your treatment.

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