A new study presented during the annual meeting of American Society of Anesthesiologists suggests cannabis use prior to surgery may increase acute pain and require more anesthetic during surgery.
The study conducted compared patient's who either used or did not report using cannabis prior to undergoing general surgery for a broken leg. Those who reported using cannabis prior to surgery also reported greater pain while in the hospital. In fact, these patients required 58% more opioids during their hospital stay. In addition, cannabis users required more anesthesia during surgery than those who did not report using cannabis prior to surgery.
We asked Dr. Saranita (double board certified anesthesiologist and pain management) what it means to require more anesthesia during surgery and here's what she had to share, "General anesthesia is a combination of medications that put you in a sleep state. General anesthesia uses a combination of inhaled gasses and intravenous medications. These combined, induce sleep along with ensuring a patient does not experience pain or have awareness. During surgery we monitor a patient's breathing, blood pressure, heart rate, involuntary movements and other key signs to adjust the amount of medication given to the patient during surgery."
Dr. Saranita adds, "Patients who used cannabis in the study exhibited symptoms of pain during surgery. They were observed to have increased heart rate, breathing and involuntary movements. As a result, their provider had to administer more anesthesia."
The research findings add to existing research that like people who chronically use opioids, cannabis users may have a similar effect of exaggerated pain and increased need for anesthesia during surgery.
Evidence supports the use of cannabis for chronic and nerve pain, however more study is needed to understand the use and its effect on acute pain. Dr. Paez (double board certified anesthesiology and pain management) shares, "The way you use cannabis (smoking, edibles, etc.), how often you use it and how much you use all affect how your body will respond to anesthesia. Since cannabis and anesthesia both affect the central nervous system, people who use cannabis need to be honest with their physician. Your health care team will not judge you or share the information. This is something as your physician I need to be prepared and I need my team to be prepared to manage the risks of increased complications such as decreased blood pressure and delayed awakening from anesthesia."
Dr. Paez adds, "This is an important study, which underscores the need for further research on cannabis and acute pain. Because of cannabis classification as a drug of abuse we cannot do medical research at South Lake Medical Research (a research arm of South Lake Pain Institute) without legislation that allows that research, and this includes cannabis impact on acute pain, and anesthesia. The American Society of Anesthesiologists has urged the federal government to allow medical studies and has endorsed bills to expand research in cannabis."
Both Dr. Paez and Dr. Saranita encourage patients to be honest with their provider. Dr. Saranita adds, "The American Society of Anesthesiologists has a list of key items you should share with your provider prior to undergoing anesthesia, these include cannabis use and the following:
