Cannabis Users Face Specific Risks During Surgery That Anesthesiologists Should Know
A review of 17 studies found that chronic cannabis users face increased risks of heart attack after surgery, greater postoperative pain and opioid use, potential bronchospasm, and drug interactions with anticoagulants.
Quick Facts
What This Study Found
Preoperative screening for chronic cannabis use was recommended due to increased risk of postoperative myocardial infarction, higher postoperative pain and opioid requirements, risk of bronchospasm requiring ventilation adjustments, and potential interactions between cannabinoids and anticoagulant medications.
Key Numbers
209 records screened, 17 included. Literature span: 2003-2023. Key risks identified: postoperative MI, increased opioid use, bronchospasm, anticoagulant interactions.
How They Did This
Review following PRISMA 2020 guidelines, searching Medline and Cochrane Library databases for reports published 2003-2023. Of 209 records identified, 17 articles were included covering perioperative management of long-term cannabis users.
Why This Research Matters
With cannabis use increasing, anesthesiologists are encountering more patients who use regularly. Knowing the specific perioperative risks allows for better preoperative screening, intraoperative management, and postoperative pain protocols.
The Bigger Picture
As cannabis becomes legal in more jurisdictions, perioperative cannabis management is transitioning from an occasional concern to a routine consideration. Standardized screening protocols and clinical guidelines will likely be needed, similar to existing protocols for tobacco and alcohol use.
What This Study Doesn't Tell Us
Only 17 studies met inclusion criteria, suggesting limited high-quality evidence. Most included studies were observational or case reports. Cannabis products vary widely in composition, making generalization difficult. Review covered only two databases.
Questions This Raises
- ?How long before surgery cannabis users should abstain to reduce perioperative risk
- ?Whether CBD-only products carry the same perioperative risks as THC-containing products
Trust & Context
- Key Stat:
- Evidence Grade:
- Systematic search with PRISMA methodology, but limited number of included studies and mostly low-quality evidence base.
- Study Age:
- Published 2025, reviewing literature from 2003-2023.
- Original Title:
- Perioperative management of the patient on cannabis and cannabinoids: A review.
- Published In:
- Journal of perioperative practice, 35(10), 456-462 (2025)
- Authors:
- Scheuermann, Maria, Hans, Guy, Wildemeersch, Davina
- Database ID:
- RTHC-07588
Evidence Hierarchy
Summarizes existing research on a topic.
What do these levels mean? →Frequently Asked Questions
Should I tell my anesthesiologist about cannabis use?
Yes. This review found that chronic cannabis use can affect how your body responds to anesthesia, pain medications, and blood thinners. Disclosure allows your medical team to adjust their approach for safer care.
Why might cannabis users need more pain medication after surgery?
Regular cannabis use may lead to cross-tolerance with opioid pain medications. The endocannabinoid system and opioid system overlap in pain processing, so chronic activation of one can reduce the effectiveness of drugs targeting the other.
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Cite This Study
https://rethinkthc.com/research/RTHC-07588APA
Scheuermann, Maria; Hans, Guy; Wildemeersch, Davina. (2025). Perioperative management of the patient on cannabis and cannabinoids: A review.. Journal of perioperative practice, 35(10), 456-462. https://doi.org/10.1177/17504589251320804
MLA
Scheuermann, Maria, et al. "Perioperative management of the patient on cannabis and cannabinoids: A review.." Journal of perioperative practice, 2025. https://doi.org/10.1177/17504589251320804
RethinkTHC
RethinkTHC Research Database. "Perioperative management of the patient on cannabis and cann..." RTHC-07588. Retrieved from https://rethinkthc.com/research/scheuermann-2025-perioperative-management-of-the
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.