Marijuana and Surgery

How Marijuana Can Affect Your Surgery

anesthesia
Marijuana Can Complicate Your Surgery.

Marijuana can complicate surgery, and should be avoided in the weeks and even months prior to your procedure.  Much like smoking cigarettes, abstaining from marijuana in the weeks before surgery can decrease the likelihood of complications during and after surgery.

Research on the topic of marijuana use and the effects during surgery is limited, but should become more plentiful in the future as medicinal marijuana has been legalized in multiple states, making it easier to gather scientific data on the topic.

 

Risks of Smoking Marijuana

Contrary to popular wisdom, marijuana smoking is not a healthier option than cigarettes, and can lead to lung cancer and other respiratory problems.  The process of inhaling large amounts of marijuana, then holding it in the lungs for extended periods of time to increase the amount absorbed, leads to increased exposure to cancer causing chemicals.  The chronic coughing, wheezing and difficulty breathing that long term cigarette smokers experience also occurs in marijuana users. 

Marijuana and Anesthesia

Smoking marijuana regularly leads to the same risks of complications faced by patients who smoke cigarettes.   This means that marijuana smokers are more likely than non-smokers to be on the ventilator longer, have higher risk of developing pneumonia after surgery and greater scarring of incisions.

The use of marijuana, especially immediately prior to surgery, can change the doses needed for sedation.

  One commonly used medication, Propofol, requires substantially higher doses for the patient who routinely uses marijuana.  One study looked at the doses required to intubate patients who routinely smoked marijuana with non-marijuana using patients, and the individuals who used marijuana required a dramatic increase in sedation.

 

One patient who smoked marijuana 4 hours prior to surgery was the topic of another case study, after experiencing an airway obstruction during the procedure.  This is a very serious complication that can lead to death, and is believed to have been caused by airway hyperreactivity, a condition known in cigarette smokers but previously unidentified in marijuana users.  It is also believed that regular users of marijuana-whether it is smoked or eaten-are more likely to experience agitation 

Marijuana Effects During Surgery

Use of marijuana in the day before surgery, and especially in the hours prior to the procedure, can cause more dramatic effects.  While some people are tempted to use marijuana prior to surgery in an effort to relax or be less stressed before the procedure, this is a very bad idea and can cause problems.  Marijuana causes causes the blood vessels of the body to relax, a process called vasodilation. This process can cause the blood pressure to fall and the heart rate to increase.

These, in turn, can complicate matters if the patient’s blood pressure is falling due to issues with the surgery, and can change the way the body responds to anesthesia.

Tell the Truth About Marijuana Use

It is very important that you are candid with the anesthesia provider about your personal use of marijuana. This means giving an accurate report of how much and how often you use marijuana, whether you eat it or smoke it, and when you last did so.  It is unlikely that your use will delay your surgery, but it is important that the anesthesia provider understands the potential for your body to need more anesthetic than is typical.  The anesthesia provider also needs to be prepared for any airway issues that may arise, which are more common in smokers of all types compared to non-smokers.

After Surgery

Smoking marijuana after surgery can slow your wound healing and increase scarring of your incisions.  Much like cigarettes, smoking marijuana decreases the amount of oxygen available to the tissues and skin of your incision site, delaying healing and making scarring more likely.  In turn, this will slow your recovery as a whole and will increase your risk of infection.  

How to Prevent and Minimize Scarring After Surgery

Source:

The Perioperative Implications of Tobacco, Marijuana, and Other Inhaled Toxins. E. Bryson and E. Frost. Accessed August, 2015.

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