First US guidance published on cannabis use in surgery patients
Cannabis Health News
All patients undergoing a procedure requiring anaesthesia should be screened for cannabis use, according to new guidance published in the US. The first guidelines on cannabis use in relation to surgery have been issued by the American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine), prompted by concerns that cannabis can potentially interact with anaesthesia. About 10% of Americans use cannabis monthly, and it is the most commonly used psychotropic substance after alcohol, according to the US Substance Abuse and Mental Health Services Administration. However, studies have shown that it can potentially interact with anaesthesia and lead to complications. The guidelines also note that regular use may worsen pain and nausea after surgery and increase the need for opioids. They recommend anaesthesiologists screen all patients for cannabis use, including asking about the type of cannabis product used, how it was used, (for example smoked, ingested), amount used, how recently it was used and frequency of use. The guidance is based on an extensive literature review and experiences from the organisation’s Perioperative Use of Cannabis and Cannabinoids Guidelines Committee, which is composed of 13 experts, including anesthesiologists, chronic pain physicians and a patient advocate. The committee addressed nine questions and made 21 recommendations using a modified Delphi consensus method with more than 75% agreement required for recommendation. All 21 recommendations achieved full consensus. This is the first US-based guideline on perioperative (before, during and after surgery) management of cannabis, according to lead researcher Shalini Shah, MD, vice chair of anaesthesiology at the University of California at Irvine School of Medicine. The guidelines cover preoperative, intraoperative and immediate postoperative care considerations. They are not intended to replace clinical judgement but rather promote improved patient communication and possibly improved outcomes. The American Society of Anesthesiologists reviewed the guidelines and is in…
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