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Cannabis users need up to twice the sedation for medical procedures, small study says



With the "continued increase in the legalization and use of cannabis, the field of anesthesia and sedation needs further studies with greater depth," wrote the authors of the study published in the Journal of the American Osteopathic Association in 19659002. Marijuana has gained popularity around the globe in recent years, due in part to the changing laws. Between 2007 and 2015, the use of marihuanda increased by 43% in the United States, where an estimated 13.5% of adults use cannabis, according to a United Nations report. Meanwhile, the estimated use of cannabis use around the world to include 183 million people, or nearly 4% of the adult population, in 201

5.

How does the growing use of cannabis affect medical care? Researchers at the Community Hospital in Grand Junction, Colorado, explored one small area of ​​medical care: sedation. They reviewed the medical records of 250 patients who received endoscopic procedures between January 1, 2016 and December 31, 2017 – years after the state legalized recreational marihuana in 2012.

Comparing the users of cannabis to nonusers, they found that Patients who reported a smoker or using edibles on a daily or weekly basis needed 14% more fentanyl, 20% more midazolam and 220% more propofol to achieve optimal sedation for routine procedures, including colonoscopies. For example, it took 13.83 milligrams of propofol, in average, for 225 nonusers to float into unconsciousness, compared with 44.81 milligrams needed, in average by 25 cannabis users.

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The study authors note that some sedatives have side effects and the higher the dose, the greater likelihood for problems. They wrote.

Too few study participants

Dr., Ph.D., Ph.D. Roderic Eckenhoff, a professor of anesthesia at the University of Pennsylvania, said the study was interesting but lacked rigor. "I would consider this a pilot study that maybe somebody should pick up and do a more complete trial," said Eckenhoff, who was not involved in the research.
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One factor that bothered him was that the study was retrospective: The researchers simply examined medical records and compared whatever The amount of sedation was used for each patient instead of controlling exact amounts of sedation and comparing the effects.

What is considered "sufficient" depends a lot on the individual providers and surgeons involved, Eckenhoff said. This "uncertainty" combined with a small number – just 25 – of cannabis-using patients makes the results "really tenuous at best," he said.

Similar results have not been seen in previous research, he said: "Even if you give someone a propofol for a long time, they get a little tolerant to it, but not by 200%." Although upward of 200% of the "resistance" may be "possible, I'd be surprised if that's been up in a bigger study," he said.

Finally, he noted that patients are not always reliable and do not necessarily tell their doctors about "everything else they take", and this may have influenced the results: "Some people who use marihuana also take other drugs recreationally. "


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