Study examines cannabis use and medical procedures

#CORE_rendSocialEmbed_Story ($ storyBody)

A small-scale study found that people who regularly consume cannabis may need twice as much sedation as non-users in medical procedures. fentanyl, midazolam and propofol, three sedation drugs commonly used in endoscopic procedures were compared as part of the research.

With "the continued increase in the legalization and use of cannabis, the field of anesthesia and sedation requires further study," wrote the authors of the study, published Monday in the Journal of the American Association of Osteopaths.

A wider use follows the legalization

Marijuana has gained popularity around the world in recent years, partly because of changing laws. According to a United Nations report, between 2007 and 2015, marijuana use increased by 43% in the United States, where about 13.5% of adults consume cannabis. In 2015, it was estimated that 183 million people, nearly 4% of the adult population, had used cannabis worldwide.

How is the growing use of cannabis affecting medical care? Researchers at the Grand Junction, Colorado, community hospital have explored a small area of ​​medical care: sedation. They reviewed the medical records of 250 patients who underwent endoscopic surgery between January 1, 2016 and December 31, 2017 – years after the state had legalized marijuana for recreational purposes in 2012.

Comparing cannabis users with non-users, they found that patients who reported daily or weekly smoking or consuming food products needed 14% more fentanyl, 20% more midazolam and 220% more propofol to obtain optimal sedation for routine procedures, including colonoscopies. For example, it took 13.83 milligrams of propofolon average, 225 non-users lost consciousness compared to an average of 44.81 milligrams of 25 cannabis users.

The authors of the study note that some sedatives have side effects and that the higher the dose, the greater the probability of problems. Ask questions about cannabis use during consumption "can be an important tool for planning patient care and badessing both drug needs and possible risks during endoscopic procedures," they wrote.

Too few participants in the study

Dr. Roderic Eckenhoff, a Professor of Anesthesia at the University of Pennsylvania, this study is interesting but lacks rigor. "I would consider this as a pilot study on which perhaps one should embark on and do a more comprehensive test," m said Eckenhoff, who did not participate in the research.

One of the factors that bothered him was that the study was retrospective: the researchers simply looked at the medical records and compared the amount of sedation used for each patient instead of controlling the exact amounts of sedation and comparing the effects.

What is considered "enough" depends a lot on the providers and the surgeons involved, Eckenhoff I said. This "uncertainty" combined with a small number – only 25 – of cannabis users makes the results "at best tenuous," he said.

Similar results have not been seen in previous research, he said: "Even if you give somebody a propofol for a long time, they become a little tolerant, but not 200%." Although more than 200% "resistance" may be "possible, I would be surprised if this is retained in a larger study," he said.

Finally, he noted that patients are not always reliable and do not necessarily tell their doctor "everything that they take," and this may have influenced the results: "Some people who use marijuana also take other drugs for recreational purposes."