August FY 22

[mary clothier]

1. What are the effects of Cannabis that the article mentions?

The use of Cannabis effects hemodynamics, specifically the cardiovascular, and pulmonary systems.
The most important aspect of cannabis use in our patients is the increased anesthetic requirements.
The potential of "poly" recreational drug use should be a consideration and included in our pre-op evaluation, questioning.

2. Do you have any concerns about a patient or a planned anesthetic after you learn your patient is using Cannabis.

With an increase in Cannabis use in our patient population from 10% in an 08-09 study to a 20% in a MA study in 18, we must consider a much higher percentage of our patients
using Cannabis. The potential for "poly" recreational drug use is more concerning.
I have seen an increase anesthetic requirement in our recreational/medicinal cannabis using patients.

[Amy Swank]

1. what are some of the effects of cannabis that the article mentions?

Airway irritation and increased mucous production (as with smokers in general), delayed gastric emptying, tachycardia, delayed gastric emptying.

2. Do you have any concerns about a patient or planned anesthetic after you learn the patient is using cannabis?

As our population seems to use cannabis more and more, we are seeing more patients admit to using. I think I share the concern with regards to other commenters like Kelsey L. and Amy Schutter said - what other self-medicating do these patients do? Do I need to increase my anesthesia due to increased tolerance? Would this patient benefit from some anxiolysis that may also help with the myoclonic movements as Anne McNulty mentions in her post? Perhaps some glyco for that patient with regards to an EGD where increased mucous production would be a danger.
If the patient is taking street cannabis, what other potential components are in that patient's source - perhaps be prepared for an unusual response/ need for anesthesia.

Thanks for the article!