The increasing use of cannabis, both recreationally and for medical purposes, has raised important questions regarding its impact on surgical procedures. Understanding cannabis’s physiological interactions with the body, especially during anesthesia, is a growing focus for healthcare providers. This article guides cannabis users facing surgery.
How Cannabis Affects Your Body During Surgery
Cannabis can interact with anesthesia and influence various bodily systems, posing specific considerations during surgical procedures. Regular cannabis users may require higher doses of anesthetic agents to achieve and maintain the desired depth of anesthesia. Studies suggest that chronic cannabis users might need significantly more propofol, an intravenous anesthetic, for induction. This increased requirement can make it more challenging for anesthesiologists to predict and manage a patient’s response to medication.
Marijuana use can also affect the respiratory system, particularly when smoked. Smoking cannabis can lead to airway inflammation, increased phlegm production, coughing, and wheezing, similar to the effects seen in tobacco smokers. These respiratory issues can complicate the placement of a breathing tube for anesthesia and increase the risk of breathing problems during and after surgery. Swelling of the uvula, known as uvulitis, can also occur, potentially leading to airway obstruction.
The cardiovascular system is also susceptible to the effects of cannabis. Marijuana can cause fluctuations in heart rate and blood pressure, which can be unpredictable and complicate their management during surgery. Acute cannabis use, especially within hours of a procedure, has been associated with an increased risk of heart attack, particularly in patients with existing heart conditions. These cardiovascular changes necessitate careful monitoring by the surgical team.
Cannabis use can influence pain management both during and after surgery. Some studies suggest that regular cannabis users may experience more pain after surgery compared to non-users, potentially requiring higher doses of opioids for pain relief. This altered pain perception and increased need for pain medication can complicate postoperative recovery and may increase the risk of opioid use. Additionally, cannabis users may be more prone to postoperative nausea and vomiting.
Recommended Cessation Period
Determining the ideal period to stop cannabis use before surgery involves several factors. Recommendations often vary based on the frequency and method of cannabis use, as well as individual metabolism. The goal of cessation is to allow the body to clear cannabinoids and reduce potential risks during the perioperative period.
General guidelines suggest stopping cannabis products at least 72 hours before general anesthesia. For frequent or heavy users, some experts recommend abstaining for a longer duration, ideally at least 14 days prior to surgery, to minimize complications. If the surgery is less than 7-14 days away, completely stopping cannabis use might not be advised due to the potential for withdrawal symptoms, which could add further complications.
These recommendations aim to mitigate risks such as interactions with anesthetic agents, cardiovascular instability, and respiratory issues. The time needed for cannabinoids to clear the system can vary significantly, with effects peaking within minutes to hours for inhaled cannabis and lasting longer for edibles. Discussing your specific cannabis use patterns with your healthcare team allows them to provide tailored advice for your situation.
Why Open Communication with Your Healthcare Team is Essential
Open communication with your healthcare providers is essential when preparing for surgery. Withholding information about cannabis use can compromise patient safety, as medical professionals rely on this information to make informed decisions. This transparency allows the surgical team to anticipate potential complications and adjust your treatment plan accordingly.
Your surgeons and anesthesiologists need to understand your cannabis use, including the type of product, how much you use, and when you last used it. This information helps them determine appropriate anesthesia dosages and manage potential interactions with other medications. Healthcare providers require a complete picture of your health to provide the safest and most effective care.
Disclosing cannabis use enables the team to plan for postoperative recovery, including pain management and monitoring for withdrawal symptoms. They can tailor medication dosages and provide supportive care for any challenges. This open dialogue ensures your medical team can proactively address cannabis-related risks, rather than react to unexpected issues during or after your procedure.
Managing Potential Withdrawal Symptoms
For individuals who use cannabis regularly, stopping abruptly before surgery can lead to uncomfortable withdrawal symptoms. These symptoms typically manifest within 24 to 72 hours after the last use and may peak within 2 to 6 days. Common withdrawal symptoms include irritability, anxiety, restlessness, and disturbed sleep.
Physical symptoms such as decreased appetite, weight loss, headaches, sweating, chills, and stomach pain can also occur. In some cases, mood changes like depressed mood or even aggression may be experienced. These symptoms, while generally not life-threatening, can be distressing and potentially complicate the preoperative period.
If you anticipate experiencing withdrawal symptoms, discussing these concerns with your healthcare provider is important. They can offer strategies to manage these symptoms and ensure your comfort before and after surgery. For severe withdrawal symptoms, your medical team might consider specific interventions, such as initiating a cannabinoid agonist. Addressing withdrawal proactively helps ensure a smoother and safer surgical experience.