A presentation at the 2022 Digestive Disease Week showed evidence that cannabis consumers require higher levels of anesthesia in preparation for a gastric endoscopy. This diagnostic procedure involves inserting a small tube attached to a microscopic camera to capture images of the upper digestive tract. During the conscious sedation procedure, the patient is relaxed and comfortable but partially conscious with the help of anesthesia in order to minimize throat irritation and gag reflex caused by the inserted tube and camera scope. The study showed that cannabis users required an increased higher total sedation to achieve a state of ideal state of partial consciousness in order to provide a more comfortable diagnostic experience.
The prospective cohort study included 419 adult outpatients undergoing endoscopic procedures. Each patient completed two questionnaires; one survey prior to the procedure about their cannabis use and another afterwards questionnaire about their awareness and comfort level during the procedure. Researchers analyzed questionnaire responses and details about the use of the sedatives midazolam, fentanyl, and diphenhydramine during the procedure. Increased sedation was defined as more than 5 mg of midazolam, more than 100 mcg of fentanyl, or the need for diphenhydramine. Although cannabis use was associated with a need for increased sedation for an endoscopy, it was not associated with higher use of sedation during a colonoscopy. Lead researcher Yasmin Nasser, M.D., Ph.D. explained that “patients didn't have increased awareness or discomfort during procedures, but they did require more drugs.” Future research will explore the mechanisms involved in the need for increased sedation for specific procedures.
Disclosing cannabis use may be difficult for some patients given the historical stigma associated with cannabis use and its illegal status in many states but sharing cannabis use frequency and amount of cannabis use with health professionals is important. Discussing cannabis use with medical professionals is critical for developing safe anesthetic preparation. Physicians in states with legal cannabis are revising treatment plans that minimize medical procedure risks based for patients who use cannabis.
Source:
Eureka News Alert, 2022 Digestive Disease Week