Perioperative management of the patient on cannabis and cannabinoids: A review.

Abstract

Background: The rise in global cannabis use has led anaesthetists to encounter an increasing number of patients on cannabis and cannabinoids. With cannabis influencing the perioperative period, anaesthetists will face associated challenges managing these patients.

Objective: This review aims to summarise this literature on perioperative care for patients with long-term cannabis consumption or cannabis use disorder.

Methods: This review was conducted based on the PRISMA 2020 statement. A literature search was performed using Medline and Cochrane library databases to identify relevant reports published from 2003 to 2023. This search yielded 209 records. After screening, 17 articles were included.

Results: Preoperative screening of patients for chronic cannabis use or cannabis use disorder can be valuable, due to the increased risk of postoperative myocardial infarction, more postoperative pain and opioid use. Moreover, regarding respiratory management, anaesthetists should prepare to manage bronchospasm and consider adjustments in ventilation. During the perioperative period, attention should be paid to potential interactions between anticoagulant medications and cannabinoids.