Cannabis users often require higher and less predictable doses of propofol during endoscopy, and inhalation users face increased airway risks including bronchospasm.
Anesthesiologists, GI endoscopists, sedation nurses, cannabis users preparing for procedures
What the researchers found
This narrative review found that cannabis users frequently need higher doses of propofol and other sedatives for GI endoscopy. Inhalation-based cannabis use is associated with airway hyperreactivity, increasing the risk of bronchospasm and laryngospasm. Cardiovascular effects including tachycardia and hypertension may also complicate sedation. Acute intoxication can impair the ability to provide informed consent.
Why it matters
With cannabis use increasingly common, sedation providers for routine procedures like colonoscopies need to anticipate altered drug responses in cannabis users. The practical implications for dosing, airway management, and consent are directly relevant to clinical practice.
The numbers in context
Review article; specific effect sizes vary across cited studies; key concerns: higher propofol requirements, airway hyperreactivity, cardiovascular effects (tachycardia, hypertension), impaired consent capacity with acute intoxication
How the study worked
Narrative review summarizing existing literature on the pharmacology of cannabis and its implications for sedation during GI endoscopy procedures.
What this study cannot tell us
Narrative review without systematic methodology. Most evidence comes from case reports and small studies. Effects during routine screening procedures may differ from complex therapeutic endoscopy.
How to read the evidence
Moderate: narrative review synthesizing clinical evidence, but without systematic methodology or meta-analysis.
When this study was published
2025 review article
The bigger picture
As cannabis legalization expands, the proportion of patients presenting for procedures with recent cannabis exposure will continue to grow, making this a routine rather than exceptional clinical consideration.
Questions still open
- Should pre-procedure questionnaires specifically screen for cannabis use timing and route?
- What propofol dose adjustments are appropriate for regular cannabis users?
Read the original research
Perioperative Repercussions of Cannabis Use-Implications for GI Endoscopy Sedation.
Journal of clinical medicine, 14(19)
Citation
Goudra, Basavana; Green, Michael. (2025). Perioperative Repercussions of Cannabis Use-Implications for GI Endoscopy Sedation.. Journal of clinical medicine, 14(19). https://doi.org/10.3390/jcm14197028
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