By Hugo Elliot
The American Society of Regional Anesthesia and Pain Medicine released brand new guidelines pertaining to marijuana use in early January 2023. The guidelines are meant to underscore how regular marijuana use can negatively impact anesthesiology and its ability to relieve pain following surgery.
Anesthesiologists have historically advised their patients not to use marijuana on the same day as a surgical procedure. They have warned patients that getting high prior to surgery, in hopes that doing so will alleviate their pain, is often counterproductive. The new guidelines go one step further.
Report Chronic Pot Use
The new guidelines encourage anesthesiologists to routinely ask about cannabis consumption. Anesthesiologists should be asking whether patients are using. And if they are, additional questions should be asked:
- How much is being consumed?
- How often is it being consumed?
- How is it being consumed?
- What type of marijuana is being consumed?
At the end of the day, anesthesiologists want their patients to report chronic pot use so that they know exactly what they are looking at when it is time to anesthetize. If a patient arrives for a procedure under the influence of marijuana, an anesthesiology is advised to postpone the procedure.
Pot Influences Anesthesia Effectiveness
One of the biggest concerns right now is that pot use influences the effectiveness of anesthesia. The new guidelines suggest that more anesthesia might be necessary to keep a chronic pot user asleep during surgery. If the anesthesiologist does not know the patient’s history with pot, it is entirely possible that the patient could wake up during the procedure.
Long-term cannabis use can also reduce the effectiveness of post-surgical pain relief. The patient who came to the procedure already high on marijuana could find him or herself highly agitated during recovery. The patient would be at higher risk of panic attacks, increased heart rate, and confusion.
Not Looking to Postpone
Under the new guidelines, anesthesiologists are not looking to postpone procedures unless they need to for the safety of the patient. Postponement is not necessary as long as a patient doesn’t arrive for the procedure already under the influence.
The guidelines are intended more to provide anesthesiologists with all the information they need to proceed safely. They need to know what to expect from their patients as they work out pre-surgical treatment plans. They need to know which drugs to use, how much to use, and how to provide pain relief during recovery.
When anesthesiologists have all the information, they are also fully aware of any and all risks the patient faces. They are in a better position to treat the patient safely and effectively.
Medical Cannabis Isn’t Different
For the record, the new guidelines apply in a medical cannabis scenario as well. Anesthesiologists need to know exactly what a patient is using and how often it is being used. Otherwise, they cannot make informed decisions.
Taking things one step further, medical cannabis pharmacists appreciate getting the same detailed information from their patients. At Pure Utah, one of just over a dozen medical cannabis dispensaries in Utah, pharmacists appreciate when patients give them as much information as possible. More information facilitates better medical recommendations.
Whether it is dispensaries in Utah or other states, there may be cases where pharmacists are willing to consult with a patient’s anesthesiologist prior to surgery. Both medical professionals would benefit from such a consultation in terms of providing better care.
At any rate, new ASRA Pain Medicine guidelines for pot use have been released. If you are a cannabis user and scheduled for future surgery, expect your anesthesiologist to ask lots of questions.
