A daily cannabis user had a dangerous aspiration risk during surgery from delayed stomach emptying he did not know about
A 24-year-old daily cannabis user who fasted appropriately before surgery still had 500 mL of gastric contents, raising concerns that THC-induced gastroparesis may create hidden aspiration risks.
Quick Facts
What This Study Found
Despite standard fasting (last meal at 10 PM the prior night), a daily cannabis user had 150 cc of gastric contents fill the airway device upon anesthesia induction, with 500 cc total suctioned from the stomach. The patient was asymptomatic for gastroparesis beforehand.
Key Numbers
Age 24; BMI 22; daily marijuana use; last meal at 10 PM; 150 cc filled the airway device; 500 cc clear gastric contents suctioned from stomach; no aspiration into lungs; uneventful recovery
How They Did This
Case report of a 24-year-old male daily cannabis user who presented for elective orthopedic surgery and experienced near-aspiration during anesthesia induction.
Why This Research Matters
Standard pre-surgical fasting guidelines assume normal gastric emptying. If chronic cannabis use causes asymptomatic gastroparesis, current fasting protocols may be insufficient for daily users.
The Bigger Picture
This case raises a systemic question: should anesthesiologists modify their approach for the millions of daily cannabis users undergoing surgery, given the potential for unrecognized gastroparesis?
What This Study Doesn't Tell Us
Single case report cannot establish incidence. No gastric emptying study was performed. The relationship between cannabis dose, chronicity, and gastroparesis risk is unknown. Other causes of delayed emptying were not fully ruled out.
Questions This Raises
- ?Should pre-operative screening ask about cannabis use?
- ?What percentage of daily cannabis users have subclinical gastroparesis?
- ?Should fasting guidelines be extended for chronic cannabis users?
Trust & Context
- Key Stat:
- 500 mL of gastric contents found despite proper pre-surgical fasting
- Evidence Grade:
- Single case report raising a safety concern without established incidence data
- Study Age:
- Published in 2021. The incidence of THC-induced gastroparesis in surgical patients has not been studied.
- Original Title:
- A Reason to Rethink Fasting Guidelines? Marijuana-Induced Gastroparesis and the Implications for Aspiration Risk in the Nil Per Os (NPO) Patient: A Case Report.
- Published In:
- The American journal of case reports, 22, e934187 (2021)
- Authors:
- Cammarano, Caitlin A, Villaluz, Joseph Evan
- Database ID:
- RTHC-03041
Evidence Hierarchy
Describes what happened to one person or a small group.
What do these levels mean? →Frequently Asked Questions
Can cannabis affect surgery safety?
This case shows chronic cannabis use may cause asymptomatic delayed stomach emptying, creating aspiration risks during anesthesia even when standard fasting guidelines are followed.
Should cannabis users tell their anesthesiologist?
Yes. This case suggests daily cannabis users may need modified fasting protocols or additional aspiration precautions during anesthesia, even if they have no digestive symptoms.
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Cite This Study
https://rethinkthc.com/research/RTHC-03041APA
Cammarano, Caitlin A; Villaluz, Joseph Evan. (2021). A Reason to Rethink Fasting Guidelines? Marijuana-Induced Gastroparesis and the Implications for Aspiration Risk in the Nil Per Os (NPO) Patient: A Case Report.. The American journal of case reports, 22, e934187. https://doi.org/10.12659/AJCR.934187
MLA
Cammarano, Caitlin A, et al. "A Reason to Rethink Fasting Guidelines? Marijuana-Induced Gastroparesis and the Implications for Aspiration Risk in the Nil Per Os (NPO) Patient: A Case Report.." The American journal of case reports, 2021. https://doi.org/10.12659/AJCR.934187
RethinkTHC
RethinkTHC Research Database. "A Reason to Rethink Fasting Guidelines? Marijuana-Induced Ga..." RTHC-03041. Retrieved from https://rethinkthc.com/research/cammarano-2021-a-reason-to-rethink
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.