#299 Cannabis And Anesthesia

Cannabis has gone mainstream, but perioperative risk has not improved. THC products are far more potent than they were decades ago, emergency room visits are climbing, and many patients still walk into surgery thinking that it’s safe. We want anesthesia professionals to have a clearer, evidence-informed way to think about cannabis and anesthesia before the next case.

We open the latest APSF newsletter feature article, “Cannabis and Anesthesia,” and bring in author Trisha Meyer to frame why this topic matters now. Together, we walk through the pharmacology that shows up at the bedside: THC vs CBD, CB1 and CB2 receptors, the endocannabinoid system, and how route of use changes onset and duration. Then we get practical about drug-drug interactions and highlight a free interaction-checking resource you can use in real time.

From there, we map cannabis use across the perioperative timeline. Preop means asking better questions and documenting details like product type, dose, frequency, last use, and withdrawal symptoms, plus knowing when intoxication should delay elective surgery and when cardiac risk may need more workup. Intraop means expecting possible higher propofol and sedative requirements, watching for cardiovascular instability, and preparing for airway hyperreactivity and bronchospasm in inhaled users. Postop means planning for higher pain needs, using multimodal analgesia, and recognizing withdrawal, hypothermia, and shivering patterns that can surprise teams.

If you care about perioperative patient safety, listen, share this with a colleague, and subscribe so you don’t miss what’s next.

For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/299-cannabis-and-anesthesia/

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