• Curr Opin Anaesthesiol · Jun 2020

    Review

    Cannabis, e-cigarettes and anesthesia.

    • Rachael S Rzasa Lynn and Jeffrey L Galinkin.
    • Department of Anesthesiology, University of Colorado School of Medicine, Aurora.
    • Curr Opin Anaesthesiol. 2020 Jun 1; 33 (3): 318-326.

    Purpose Of ReviewBoth cannabis and e-cigarette use are increasing, particularly among adolescents. The use of cannabis products may impact patients' physiology under anesthesia. Understanding the effects of cannabis and vaping are critical to the provision of safe and effective anesthetic care.Recent FindingsE-cigarettes have recently been implicated in a severe presentation of acute lung injury, often in association with vaporization of the cannabinoid, THC. E-cigarette use appears to be associated with other less-acute pulmonary adverse effects that are yet to be fully understood. Cannabis affects many organ systems with alterations in cardiovascular, respiratory and neurological function. Specifically, there is emerging evidence that cannabis use may reduce the efficacy of sedative agents and postoperative pain management efforts.SummaryThere is a very wide variety of cannabis products currently available, with respect to both route of administration as well as cannabinoid content. Patients using cannabis products prior to anesthesia may present with altered physiology that place them at increased risk for cardiovascular and respiratory complications. They may also be tolerant to the effects of propofol and opioid for pain management, thus consideration should be given to use of a multimodal regimen.

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