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article imageRegular cannabis users need more surgical anesthesia — study

By Karen Graham     Apr 16, 2019 in Health
An interesting, small-scale study on the effects of surgical sedation on regular cannabis users has turned up some interesting results that show users may need two times the level of sedation required by nonusers when undergoing medical procedures
The study, by researchers at Community Hospital in Grand Junction, Colorado, compared three sedatives used routinely in endoscopic procedures, fentanyl, midazolam, and propofol.
The researchers found that Colorado residents who regularly use cannabis needed up to twice as many powerful sedatives before a procedure as non-cannabis users. The results of the study were published in the Journal of the American Osteopathic Association.
With "continued increase in legalization and use of cannabis, the field of anesthesia and sedation needs further studies with greater depth," wrote the authors of the study.
Marijuana use in the United States increased by 43 percent between 2007 and 2015, with an estimated 13.5 percent of adults using cannabis, according to a 2017 United Nations report. Interestingly, plenty of research has been done on the use of cannabis for differing medical conditions, according to the British Medical Journal in 2015.
But the effects of regular cannabis use on surgical anesthesia is probably something that will have to be studied in greater depth. The Colorado study was a needed start. Researchers looked at the medical records of 250 patients in the state who underwent endoscopies between January 1, 2016, and December 31, 2017 - years after the state legalized recreational marijuana in 2012.
A photograph of a flexible endoscope used to look at the inside of the gastrointestinal tract.
A photograph of a flexible endoscope used to look at the inside of the gastrointestinal tract.
Benutzer:Kalumet (CC BY-SA 3.0)
An endoscopy is a procedure where a camera is sent down your throat (or other sensitive orifices) to get a closer look inside the body.
The study found that patients who reported smoking or using edibles on a daily or weekly basis required 14 percent more fentanyl, 20 percent more midazolam, and 220 percent more propofol to achieve optimum sedation for routine procedures.
CNN reports that as an example, it took 13.83 milligrams of propofol, on average, for 225 nonusers to float into unconsciousness, compared with 44.81 milligrams needed, on average, by 25 cannabis users.
Asking questions about cannabis use during intake "can be an important tool for planning patient care and assessing both medication needs and possible risks during endoscopic procedures," the researchers wrote.
According to lead author Mark Twardowski, an osteopathic internal medicine physician, the admittedly small study - only 25 patients acknowledged they were regular cannabis users - was limited, the need for more research on a larger scale would be very helpful, especially with more people using cannabis products.
“Some of the sedative medications have dose-dependent side effects, meaning the higher the dose, the greater likelihood for problems,” said Twardowski in a statement. “That becomes particularly dangerous when suppressed respiratory function is a known side effect.”
This study, while a small "first step," is just one more reason that the federal law needs to be changed to allow for more thorough studies into the medical uses of cannabis and the effects of health care procedures and pharmaceuticals on cannabis users.
More about Cannabis, Sedatives, endoscopy, small study, pain tolerance
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