Surgeons need to know their patients use cannabis because it affects every phase of surgical care

Cannabis users may require higher anesthesia doses due to tolerance, face increased rates of myocardial ischemia, and experience prolonged sedation. Postoperative effects include potentially increased pain, nausea, and vomiting. Topical cannabinoids may improve wound healing. Significant drug interactions exist with anticoagulants. Cannabis use disorder is associated with increased perioperative morbidity and mortality.

Clinical review published in JAMA Otolaryngology synthesizing evidence on how cannabis use affects surgical care phases, including preoperative, intraoperative, and postoperative considerations.

With cannabis use rising and many patients not disclosing it, surgeons may be managing anesthesia, pain, and medications without knowing about a substance that affects all of these. The consequences range from inadequate anesthesia to dangerous drug interactions.

Cannabis is no longer a niche concern in surgical medicine. As use becomes more common and legal, every surgical specialty needs protocols for screening, disclosure, and adjusted care plans for cannabis users.

Review format with mixed-quality underlying evidence. Many effects described as potential or inconsistent across studies. Focused on otolaryngology context but findings apply broadly. Does not provide quantified risk estimates for most outcomes.