• Karim S Ladha, Varuna Manoo, Ali-Faizan Virji, John G Hanlon, Alexander Mclaren-Blades, Akash Goel, Duminda N Wijeysundera, Lakshmi P Kotra, Carlos Ibarra, Marina Englesakis, and Hance Clarke.
• Department of Anesthesia and the Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
• Cannabis Cannabinoid Res. 2019 Jan 1; 4 (4): 219-230.

AbstractAs countries progressively embrace the legalization of both medicinal and recreational cannabis, there remains a significant knowledge gap when it comes to the perioperative uses of cannabis, as well as the management of cannabis users. This review summarizes the information available on the subject based on existing published studies. Articles outlining the physiological changes occurring in the human body during acute and chronic use of cannabis (outside the context of anesthesia) are also taken into consideration as understanding these changes allows a more calculated approach to better anticipate patients' needs in the perioperative setting. Common questions facing the anesthesiologist at each phase of the perioperative period will be addressed and a systematic approach to the effect of cannabinoids on various organ systems will also be presented. Issues unique to cannabis use such as cannabis withdrawal syndrome and alterations in post-operative pain processing will also be discussed. To date, the number of studies available for guidance is small and study designs are markedly heterogenous, if not limited, making conclusions challenging. While the currently available information can assist in making decisions, further studies of larger scale are eagerly anticipated to help guide future patient care.Copyright 2019, Mary Ann Liebert, Inc., publishers.

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