Cannabis Users Needed More Propofol During Dental Surgery Under General Anesthesia | Research

The takeaway

Heavy cannabis users with 2-3+ years of daily use required significantly more propofol during wisdom tooth removal under IV general anesthesia.

Cannabis users facing surgery, anesthesiologists, oral surgeons, and anyone interested in cannabis-drug interactions.

Each year of cannabis exposure = 0.7 mg more propofol needed

What the researchers found

After adjusting for confounders, cannabis exposure years were significantly associated with total propofol requirements (coefficient = 0.7, 95% CI: 0.07-1.25, p = 0.03). Decision tree analysis stratified patients into high risk (2-3+ years multiple daily use), moderate risk (2-3+ years infrequent use), and low risk (<2-3 years).

Why it matters

This is directly clinically relevant: if cannabis users need more anesthesia, surgeons and anesthesiologists need to plan accordingly. The risk stratification framework offers a practical tool for assessing anesthetic requirements.

The numbers in context

49 subjects, mean age 26.7, 61.2% female, 77.6% cannabis users. Mean cannabis exposure: 55.6 years-equivalents. CEY coefficient for propofol: 0.7 mg per exposure year (p = 0.03). Bivariate correlation was r = 0.3 (p = 0.07).

How the study worked

Prospective study of 49 patients over age 21 undergoing wisdom tooth removal under IV general anesthesia at University of Washington. Cannabis exposure years (CEY) were calculated from questionnaire responses. Multivariate linear regression and decision tree analysis assessed the association with total propofol use.

What this study cannot tell us

Very small sample (49 patients). Single center. 77.6% of the sample used cannabis, creating an imbalanced comparison. Self-reported cannabis use may be inaccurate. Wisdom tooth extraction is a relatively brief procedure.

How to read the evidence

Small prospective study with only 49 subjects. Significant finding but needs replication in larger samples.

When this study was published

2026 study based on 2022-2023 data collection.

The bigger picture

As cannabis use becomes more prevalent, understanding its interactions with anesthesia becomes increasingly important for surgical safety. This study adds to growing evidence that chronic cannabis use may alter drug metabolism and receptor sensitivity.

Questions still open

Do cannabis users also require more anesthesia for longer, more complex surgical procedures? Is the increased requirement driven by pharmacokinetic tolerance, pharmacodynamic changes, or both?

Common questions

Should I tell my surgeon about cannabis use before surgery?

This study found cannabis users needed more anesthesia. Disclosing cannabis use helps anesthesia providers plan appropriate dosing for safe sedation.

How much more cannabis use makes a difference?

The study found that 2-3+ years of multiple daily cannabis use placed patients in the highest risk category for needing additional propofol.

Read the original research

Do Cannabis Users Require More Anesthesia During Third Molar Removal Under Intravenous General Anesthesia When Compared to Nonusers?

Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons

View on PubMed ↗Publisher’s paper ↗

Citation

Panesar, Kanvar S; Smith, Charles; Zhang, Zhehao; Dodson, Thomas B; Burke, Andrea. (2026). Do Cannabis Users Require More Anesthesia During Third Molar Removal Under Intravenous General Anesthesia When Compared to Nonusers?. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. https://doi.org/10.1016/j.joms.2026.01.020