When preparing for surgery, patients often consider cannabis use. Medical professionals generally advise against it or recommend careful consideration due to its potential impact on surgical outcomes. Open communication with your healthcare team is important for patient safety.
Why Cannabis Use Matters Before Surgery
Cannabis can significantly interact with anesthetic agents, influencing the amount of medication required for a surgical procedure. Regular users, particularly those with high levels of tetrahydrocannabinol (THC) exposure, may develop a tolerance to sedatives, potentially necessitating higher doses of anesthetic drugs to achieve and maintain unconsciousness. This increased requirement for anesthesia can complicate dosage management and, in some instances, elevate the risk of patients experiencing awareness during surgery.
The respiratory system can also be affected by cannabis use, particularly through smoking or vaping. Cannabis smoke contains irritants that can lead to inflammation of the airways, increased phlegm production, coughing, and wheezing. Such respiratory issues may make it more challenging for medical staff to place a breathing tube during anesthesia and can increase the risk of post-operative lung complications. Swelling of the uvula, known as uvulitis, has also been observed in some cannabis smokers, which can obstruct the airway and complicate intubation.
Cannabis use can impact the cardiovascular system, leading to changes in heart rate and blood pressure. It may cause an increase in heart rate (tachycardia) and fluctuations in blood pressure, which can be concerning during the precise physiological control required in surgery. For individuals with pre-existing heart conditions, cannabis use before surgery can increase the risk of serious events such as myocardial infarction (heart attack) or stroke.
Chronic cannabis use may also influence a patient’s response to pain management strategies after surgery. Studies indicate that individuals who regularly use cannabis might experience increased pain sensitivity and require higher doses of post-operative pain medication, including opioids, to manage discomfort effectively. This altered pain perception and potential for increased opioid needs can complicate recovery and introduce additional risks. Additionally, some research suggests a higher incidence of post-operative nausea and vomiting among cannabis users.
Recommended Cessation Period
Establishing a universal, rigid timeline for discontinuing cannabis use before surgery is challenging, as recommendations can vary based on the type of cannabis product, frequency of use, and the specific surgical procedure. However, medical guidelines offer general advice to help minimize risks. The American College of Surgeons, for instance, suggests stopping cannabis products at least 72 hours before a general anesthesia procedure.
For frequent or heavy cannabis users, some experts propose a longer abstinence period, ideally starting at least 14 days or even several weeks prior to surgery. This extended period accounts for the fact that cannabinoids are fat-soluble and can accumulate in body tissues, meaning their elimination from the system can take longer. The American Society of Regional Anesthesia and Pain Medicine (ASRA) advises postponing elective surgery for a minimum of two hours after smoking cannabis due to immediate cardiovascular risks.
It is also important to consider the method of consumption, as edibles, for example, have a longer duration of action and metabolism compared to inhaled forms, potentially requiring a longer cessation period, sometimes up to four weeks. Abruptly stopping cannabis, especially for daily users, can lead to withdrawal symptoms such as irritability, anxiety, or sleep disturbances, which could complicate the post-operative recovery phase. Therefore, any cessation plan should be discussed and managed in consultation with the surgical team.
Open Communication with Your Surgical Team
Disclosing cannabis use to your surgical team is paramount for ensuring your safety and optimizing surgical outcomes. Healthcare providers approach this information from a medical perspective, focusing on patient well-being rather than judgment. Providing a complete and accurate history of cannabis use allows the medical team to anticipate potential interactions with anesthesia and other medications, and to adjust your care plan accordingly.
It is helpful to share specific details with your team, including the type of cannabis product used (e.g., flower, edibles, oils), the method of consumption (e.g., smoking, vaping, ingesting), the frequency of use, and the date of your last use. This information enables anesthesiologists to make informed decisions about anesthetic dosages and to prepare for any potential complications.
What to Do If You’ve Already Used Cannabis
If you have used cannabis shortly before a scheduled surgery, inform your surgical team immediately. This allows your medical team to be fully aware of any substances in your system and make appropriate decisions for your safety.
Depending on the timing of your last use, the amount consumed, and the type of product, the surgical team may need to adjust the anesthesia plan. In some instances, for example, if acute intoxication is suspected or if significant risks are identified, the surgery may need to be postponed to ensure your well-being. This allows time for the cannabis to metabolize and for any immediate physiological effects to subside, reducing potential complications during and after the procedure.