Regular cannabis consumers may need twice the level of sedation while undergoing medical procedures, according to a new study published The Journal of the American Osteopathic Association. Not everyone, however, is convinced that the study makes any solid causal relationships between cannabis and anesthetics.
Investigators scoured through medical records of 250 patients that underwent procedures after Colorado legalized cannabis. Patients who smoked or ingested cannabis on a daily or weekly basis required 14 percent more fentanyl, 20 percent more midazolam, and 220 percent more propofol to achieve optimum sedation during medical procedures. There were however, only 25 patients out of the 250 participants who said they consumed cannabis regularly.
The investigators pointed out the problems of increased dosages of anesthetics. “Some of the sedative medications have dose-dependent side effects, meaning the higher the dose, the greater likelihood for problems,” lead researcher Mark Twardowski, said in a press release. “That becomes particularly dangerous when suppressed respiratory function is a known side effect.”
The team acknowledged the limited scope of the study results, and that a larger study is needed. “Cannabis has some metabolic effects we don’t understand and patients need to know that their cannabis use might make other medications less effective. We’re seeing some problematic trends anecdotally, and there is virtually no formal data to provide a sense of scale or suggest any evidence-based protocols,” Dr. Twardowski said.
But according to Dr. Roderic Eckenhoff, a professor of anesthesia at the University of Pennsylvania, the number of patients who were observed isn’t enough to make any solid correlations between cannabis and anesthesia. There were only 25 of the patients who said they smoked cannabis. In addition, calculations were all made based upon the patients’ own definition of what is “enough” anesthesia. Several individual factors between doctors and patients could have clouded the results. Eckenhoff and other scientists remain doubtful that a larger study would find 200 percent or more resistance to anesthesia in cannabis consumers.