Why marijuana increases your need for anesthesia remains unclear, largely because of its status as a federally illegal drug, which makes it difficult to research, Jeffrey Uppington, an anesthesiologist at UC Davis Medical Center, tells Mic. ItвЂ™s possible that compounds in weed called cannabinoids вЂ” which tetrahydrocannabinol (THC, which is responsible for making you feel high) вЂ” affect the same receptors in the brain and spinal cord as anesthesia drugs do.
No matter how often you consume cannabis, though, donвЂ™t use it at all on the day of your procedure, Hepner says. Taking an edible on the same day poses the added risk of inhaling it, which may result in a life-threatening lung infection called aspiration pneumonia. And if you come into the clinic high AF, you can pretty much count on your surgery being cancelled. Uppington recommends hitting pause for as many days as you can before your surgery, ideally a month, which is how long it takes for cannabis to be fully removed from the body.
Awakening mid-wisdom tooth extraction was eye-opening for Jennie. Since her doctor didnвЂ™t ask her specifically about her drug use, and she didnвЂ™t think smoking weed wouldn’t matter for her surgery, she didnвЂ™t mention it; in fact, she worried that if she did, she wouldnвЂ™t be allowed to undergo the procedure. вЂњIn the future, I would definitely inform my doctor of my cannabis use,вЂќ she says.
After surgery, you might also experience more pain, which may nudge you toward using more opioids and increase your risk of addiction to these substances, says David Hepner, the medical director of the Weiner Center for Preoperative Evaluation at Brigham and Women’s Hospital and an associate professor of anaesthesia at Harvard Medical School.
Thanks to modern-day monitors that measure brain waves and other vitals, an anesthesiologist can likely spot when a patient is about to awaken and give them more drugs before they reach that point, Uppington says. But even if you donвЂ™t wake up during a procedure, you can still have issues. If you routinely smoke weed, your airway might be more reactive during anesthesia. You might cough more, experience bronchial spasms, and/or have a more active gag reflex, which is a problem if you need to be intubated, as with general anesthesia (the kind that puts you to sleep).
вЂњSheвЂ™s waking up,вЂќ a male voice said. It was around then that Jennie remembered: She was in the dentistвЂ™s office, getting her wisdom teeth pulled. She must have awoken during the procedure. Almost as soon as she realized what was happening, the anesthesia pulled her back into sleep.
JennieвЂ™s wisdom tooth extraction left her so groggy that she needed to be transported to her car by wheelchair, and she doesnвЂ™t remember anything from the 45-minute ride home. As her fiancГ© drove, she drifted in and out of sleep, and didnвЂ™t feel like herself again for another three hours. In contrast, a friend she drove home after a dental procedure was a little groggy, but could walk to his car and felt fine when he got home, probably because he wasn’t a cannabis user, and therefore didn’t require as much anesthesia.
“If youвЂ™re a chronic user of marijuana, you are more resistant to anesthetics, both those that put you to sleep, like propofol, and those that keep you asleep, like various anesthesia gases.”
But, вЂњthatвЂ™s more speculation than we really know,вЂќ Uppington says. вЂњThe bottom line is, if youвЂ™re a chronic user of marijuana, you are more resistant to anesthetics, both those that put you to sleep, like propofol, and those that keep you asleep, like various anesthesia gases.вЂќ
One day in 2016, Jennie awoke to sharp pain and a tugging sensation on the left side of her jaw вЂ” "like my jaw was being pulled off my head," she recalls вЂ” along with the firm pressure of hands holding her mouth agape. She opened her eyes justвЂ¦
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.
If you smoke marijuana and are planning to have surgery you may be wondering if you need to stop smoking before your procedure. Like smoking cigarettes, the short answer is this: Yes, quitting today may improve your surgical outcome, how quickly you get out of the hospital and how quickly you heal after surgery.
Unfortunately, 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 (and recreational use in a growing number), making it easier to gather scientific data on the topic. We do know that marijuana, while effective for decreasing nausea and some other health-related benefits, has the potential to interact with anesthesia.
One study looked at the doses of Propofol required to intubate patients who routinely smoked marijuana with non-marijuana using patients. The individuals who used marijuana required a dramatic increase in sedation.
Like nicotine, 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.
Contrary to popular wisdom, marijuana smoking is not a healthier option than cigarettes. It 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.
Scott Sundick, MD, is a board-certified vascular and endovascular surgeon. He currently practices in Westfield, New Jersey.
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 a higher risk of developing pneumonia after surgery, and greater scarring of incisions.
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.
Smoking pot before surgery can cause problems during and after your procedure, find out why you should avoid marijuana before surgery.