| Analgesics

Perioperative Pain and Addiction Interdisciplinary Network (PAIN)

Consensus Recommendations: Perioperative Management of Cannabis

In an online edition of the British Journal of Anaesthesia, the Perioperative Pain and Addiction Interdisciplinary Networkor PAINoutlined recommendations for patients who use cannabis. The regulation and use of marijuana products is constantly evolving. Cannabis use can alter perioperative outcomes, from admission to anesthesia to surgery through recovery. Opinion and evidence about cannabis differs: does it offer analgesia or can it alter adequate depth of anesthesia? Doctors and patients must be aware of the consequences. Through a steering committee, a review of the literature, and a panel of 17 experts, recommendations are now available for the care of cannabis using patients.

Recommendations include:

  • Emphasizing the importance of eliciting a history of cannabis use
  • Quantifying cannabis use
  • Ensuring contact with a cannabis authorizer, if possible
  • Consideration of perioperative cannabis weaning
  • Additional postoperative nausea and vomiting prophylaxis
  • Additional attention to monitoring and maintaining anesthetic depth
  • Postoperative anticipation of increased postoperative analgesic requirements and maintaining vigilance for cannabis withdrawal syndrome

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