Coming clean: Your anesthesiologist needs to know about marijuana use before surgery

Male doctor sitting in operating room during surgery while holding oxygen mask and looking at the camera.

Given the rising prevalence and legalization of marijuana, many sufferers have come to assume that marijuana use is just not price mentioning to their physicians. In spite of everything, they cause, I might not essentially inform my physician that I had a glass of wine final night time, so why ought to I disclose that I smoked marijuana yesterday? Sadly, this reasoning is flawed. As a result of marijuana has quite a lot of results on the physique and on anesthesia medicines, it’s essential that anybody present process a preoperative analysis disclose their marijuana use. Don’t fear that your anesthesiologist is judging you. That’s not our job! Our job is to grasp your well being and physique as a way to give you the most secure and most pain-free process. This data is a part of your confidential medical document, and correct data is essential to serving to medical doctors present excellent care.

Marijuana can have an effect on the sort and quantity of anesthesia

The best way(s) you utilize marijuana (smoking, edibles, and so forth.), how typically you utilize, and the way a lot all can have an effect on how your physique responds to anesthesia. Since marijuana and anesthesia each have an effect on the central nervous system, individuals who use marijuana repeatedly might have completely different quantities of anesthesia medicines. With a purpose to know which medicines and the way a lot to make use of, your physician must know forward of time how a lot and the way typically you utilize marijuana.

Common customers of marijuana usually want bigger doses of anesthesia medicines as a way to obtain the identical diploma of sedation. For those who don’t inform your anesthesiologist how a lot marijuana you smoke, she or he might underestimate how a lot anesthesia will probably be wanted so that you can “fall asleep” and keep asleep throughout your process. For instance, in comparison with nonusers, common marijuana customers (day by day to weekly) want over 3 times as rather more propofol to realize satisfactory sedation for endoscopies. That may be a large enhance in dose that your physician would wish to be ready to manage.

The upper anesthesia dose required for normal marijuana customers can result in an elevated danger of issues, similar to decreased blood strain and delayed awakening from anesthesia.

Marijuana use earlier than surgical procedure can enhance the danger of issues

Different negative effects of standard marijuana use can result in severe issues of anesthesia. Inhaled marijuana can have an effect on your lungs and enhance phlegm, coughing, wheezing, and the danger of respiratory infections. These lung points can result in respiration issues throughout your anesthetic, similar to elevated airway sensitivity when the respiration tube is put into or taken out of the airway. This will likely really feel like an bronchial asthma assault, with a sensation of issue respiration and decreased oxygen stepping into the lungs. Common customers of marijuana also can have elevated postoperative ache, which results in increased opioid use throughout and after surgical procedure. This places common marijuana customers in danger for opioid use dysfunction after surgical procedure.

Don’t use marijuana the day of surgical procedure — particularly edibles

Regardless of how anxious you’re about your process, don’t use marijuana to loosen up — chances are you’ll find yourself together with your surgical procedure rescheduled or with severe issues. No matter how typically you normally use marijuana, anesthesiologists agree that you need to skip it utterly on the day of surgical procedure. You shouldn’t smoke or inhale marijuana the day of your surgical procedure, and definitely you need to keep away from any edible marijuana the day of surgical procedure, for the reason that American Society of Anesthesiologists’ tips for preoperative fasting don’t enable any stable meals for six to eight hours previous to anesthesia, as a way to lower the danger of meals getting inhaled into your lungs. This will result in aspiration pneumonia, a really severe complication that will trigger demise in some sufferers.

The bodily results of marijuana can enhance the danger of issues, particularly if consumed inside an hour or two of anesthesia. Marijuana can increase your coronary heart price and decrease your blood strain. These adjustments are much more severe in sufferers with coronary heart illness. In chosen affected person populations, this mix of decreased blood strain and elevated coronary heart price may cause ischemia (lack of blood provide) to the center muscle, generally generally known as a coronary heart assault.

There are nonetheless many unknowns about marijuana

Your anesthesiologist wants correct details about your marijuana use as a way to plan secure anesthesia, and we all know that nobody ought to use marijuana on the day of surgical procedure. Due to marijuana’s classification as a drug of abuse, we can’t do medical analysis on marijuana with out laws to permit that analysis, and this contains analysis about how marijuana impacts surgical procedures and features of anesthesia. The American Society of Anesthesiologists (ASA) has urged the federal authorities to permit medical research and has endorsed payments  to develop analysis in marijuana.

Your anesthesiologist simply needs to maintain you secure

The ASA has an inventory of eight issues that you need to inform your doctor and anesthesiologist earlier than surgical procedure, and using marijuana is considered one of them. Please don’t be afraid to reveal your use of marijuana to your doctor, because it won’t have an effect on what we consider you. You’ll assist us handle and regulate your anesthetic, forestall issues, and preserve you as secure and wholesome as potential.

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