Cannabis on the Rise: Are Perioperative Risks as Well?

As cannabis has become legalized, more and more Americans use it for recreational purposes. Nearly 18% of the U.S. population consume it in some form. Patients with a history of cannabis use frequently present for surgery and it is unclear exactly what risk they incur of increased postoperative pain and opioid use. Furthermore, postoperative hypoxemia and pulmonary complications may arise for those patients who use the inhalational route to consume cannabis. Ekrami et al reviewed the surgical records of adults undergoing general anesthesia and compared cannabis users to non-users to explore the answers to these considerations. Of adult patients undergoing general anesthesia, 1,683 cannabis users were compared to 32,838 matched controls over a 10 year period. Cannabis use was associated with increased opioid consumption, with adjusted ratio of geometric means of 1.30 (95% CI: 1.22–1.38), P<0.0001, for cannabis users versus non-users as well as increased TWA pain score, with a difference in means of 0.57 (95% CI, 0.46–0.67), P<0.0001. Cannabis use was not associated with hypoxemia or postoperative pulmonary complications, however, these questions require further research as the route and quantity of cannabis use was not available consistently from the reviewed records. A visual summary of this article is presented in this infographic, though the reader is strongly encouraged to review the cited article for a more thorough understanding of the illustrated concepts.