Cannabis users may have altered pain processing, higher anesthetic requirements, and risk of withdrawal syndrome after surgery, but the evidence base remains small and heterogeneous.
Anesthesiologists, surgeons, surgical nurses, and patients who use cannabis and are planning surgery.
Limited evidence base
What the researchers found
The review identified several perioperative concerns for cannabis users: potential increased anesthetic requirements, altered post-operative pain processing, cannabis withdrawal syndrome risk, and cardiovascular effects. However, the number of available studies is small and study designs are markedly heterogeneous.
Why it matters
With increasing cannabis use, anesthesiologists and surgeons encounter cannabis users regularly but have little evidence-based guidance. Understanding the perioperative implications is essential for patient safety.
The numbers in context
The review does not provide pooled statistics due to the heterogeneity of available studies, instead presenting a qualitative synthesis organized by perioperative phase and organ system.
How the study worked
Narrative scoping review examining published studies on cannabis use in the perioperative period, supplemented by literature on cannabis physiology outside the surgical context.
What this study cannot tell us
Scoping review limited by small number of available studies with heterogeneous designs. Many recommendations are extrapolated from non-surgical cannabis physiology studies. No meta-analysis possible.
How to read the evidence
Moderate: scoping review identifies important clinical questions but limited by small heterogeneous evidence base.
When this study was published
Published in 2019.
The bigger picture
The perioperative period represents a high-stakes gap in cannabis research. Patients may not disclose use, and clinicians may not know what to do with the information even when they have it.
Questions still open
- Should surgical patients be screened for cannabis use preoperatively? How should anesthetic protocols be adjusted for chronic cannabis users?
Common questions
Should I stop using cannabis before surgery?
Can cannabis use affect anesthesia?
Read the original research
The Impact of Perioperative Cannabis Use: A Narrative Scoping Review.
Cannabis and cannabinoid research, 4(4), 219-230
Citation
Ladha, Karim S; Manoo, Varuna; Virji, Ali-Faizan; Hanlon, John G; Mclaren-Blades, Alexander; Goel, Akash; Wijeysundera, Duminda N; Kotra, Lakshmi P; Ibarra, Carlos; Englesakis, Marina; Clarke, Hance. (2019). The Impact of Perioperative Cannabis Use: A Narrative Scoping Review.. Cannabis and cannabinoid research, 4(4), 219-230. https://doi.org/10.1089/can.2019.0054
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