According to the latest data from the National Center for Drug Abuse Statistics in the United States of America, roughly 55 million (16.9%) American adults currently use marijuana, and 45% have tried it at least once. But many aren’t aware of the drug’s effects on oral surgery. In fact, it’s so impactful that anesthesiologists must know about cannabis usage before providing sedation.
Dr. Pranathi Reddy explains that those who use marijuana regularly may require more anesthesia before undergoing oral surgery or other medical procedures
The Rising Marijuana Popularity
More states are allowing people to eat edibles and smoke pot without worrying about legal restrictions. And this fact has caused an increasing number of oral surgeons and doctors to ask about cannabis use before procedures because regular users might need more painkillers or anesthesia.
Impact of Marijuana on Anesthesia
The director of the Marijuana Investigations for Neuroscientific Discovery emphasizes the importance of disclosing cannabis use to anesthesiologists.
Dental surgeries already ask about alcohol consumption, which can also affect sedation requirements. However, most people aren’t honest about marijuana use, and some states’ dentists aren’t required to ask, posing anesthesia problems during surgery.
Currently, it isn’t clear whether the anesthesia complication is caused by THC (i.e., the primary psychoactive compound in marijuana) or CBD. While the latter won’t produce the same high as THC, it’s utilized as a pain, anxiety, or sleep remedy — and many edibles contain both components.
One oral surgeon from the Maryland Center for Oral Surgery and Dental Implants, mentions that he began noticing increased anesthesia requirements for consistent sedation a few years ago.
In his experience, regular cannabis users required almost double (and sometimes triple) the amount of anesthetic propofol to stay sedated. Sometimes, both the doctor and his colleagues would need to add other drugs sometimes utilized in sedation (e.g., ketamine and fentanyl) for patients who were restless throughout operations.
The popularity of marijuana has spurred many practices to ask more specific cannabis use questions on their health history forms.
But There’s No Need to Panic About Waking Up During Surgery
While the above may be distressing for some, patients don’t have to stress about waking up during their procedures. Anesthesiologists monitor sedation levels throughout procedures, injecting more if they realize the drugs are wearing off.
Regardless, regular marijuana users seem to need more anesthesia to go under and remain there.
Recommendations Now Require Marijuana Screening and Questioning
January 2023 saw the American Society of Regional Anesthesia and Pain Medicine outline recommendations that patients undergoing anesthesia must be screened and questioned about marijuana use. Forms should detail how much they take, how often they take it, how they take it, and when they last used it.
That said, the ongoing research into cannabis’ impacts on anesthesia means the guidelines aren’t very specific. For instance, they don’t dictate how much more sedation users will need or what usage amount requires changes.
But overall, cannabis users need to inform their oral surgeon of their habit before the procedure begins. That way, they’ll ensure proper care.
