Cannabis use and anaesthetic agent dosing in patients undergoing surgery or interventional procedures: a single-centre retrospective cohort study.

IF 10.3 1区医学 Q1 ANESTHESIOLOGY

British journal of anaesthesia Pub Date : 2026-09-29 DOI:10.1016/j.bja.2026.09.001

Nikolai Ratajczak, Elena Ahrens, Luca J Wachtendorf, Ricardo Munoz-Acuna, Simone Redaelli, Aiman Suleiman, Eva-Lotte Seibold, Max Hentges, Theresa Tenge, Dario von Wedel, Sarah Ashrafian, Béla-Simon Paschold, Guanqing Chen, Kevin P Hill, Maximilian S Schaefer

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引用次数: 0

Abstract

Background: There is limited evidence that habitual cannabis consumption increases anaesthetic requirements. We hypothesised that cannabis use affects anaesthetic dosing among patients undergoing surgery or interventional procedures.

Methods: A total of 341 199 adult patients undergoing propofol sedation or volatile-based general anaesthesia at Beth Israel Deaconess Medical Center, Boston, USA, between 2008 and 2024 were included. The primary exposure was cannabis use, differentiated into medical or non-medical use (recreational use or cannabis use disorder). Primary outcomes were propofol dose (μg kg^-1 min^-1) for monitored anaesthesia care and mean end tidal age-adjusted minimum alveolar concentration (MAC) values for general anaesthesia. In multivariable analyses, we estimated the adjusted difference in mean primary anaesthetic agent dosing.

Results: A total of 23 896 patients (7.0%) were identified as non-medical cannabis users, and 3193 (0.9%) held a certification for medical cannabinoids. In adjusted analyses, both non-medical and medical cannabis use were associated with increased propofol doses (non-medical, +6.85 μg kg^-1 min^-1^, 95% CI 6.07-7.63, P<0.001; medical, +2.87 μg kg^-1 min^-1, 95% CI 0.88-4.86, P=0.005) and doses of volatile anaesthetics (non-medical, +0.01 MAC, 95% CI 0.01-0.02, P<0.001; medical, +0.02 MAC, 95% CI 0.01-0.03, P=0.002). Estimated effects were strongest among frequent users (daily recreational users, +8.41 μg kg^-1 min^-1 propofol, 95% CI 7.00-9.81, P<0.001). At comparable propofol induction doses, non-medical cannabis users experienced greater heart rate increase after tracheal intubation (+1.45 beats min^-1, 95% CI 1.10-1.79, P<0.001).

Conclusions: Cannabis use was associated with modestly higher propofol and volatile anaesthetic doses. However, effect sizes were smaller than previously reported, and future studies should investigate the clinical relevance.

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接受手术或介入手术的患者的大麻使用和麻醉剂剂量：一项单中心回顾性队列研究。

背景：有有限的证据表明，习惯性大麻消费增加了麻醉需求。我们假设大麻的使用会影响接受手术或介入性手术的患者的麻醉剂量。方法：选取2008年至2024年在美国波士顿Beth Israel Deaconess医疗中心接受异丙酚镇静或挥发性全身麻醉的341 199例成年患者。主要暴露是大麻使用，分为医疗或非医疗使用（娱乐使用或大麻使用障碍）。主要结果是监测麻醉护理的异丙酚剂量（μg kg-1 min-1）和全身麻醉的平均终末潮汐年龄调整最小肺泡浓度（MAC）值。在多变量分析中，我们估计了平均一次麻醉剂剂量的调整差异。结果：共有23 896例（7.0%）患者被确定为非医用大麻使用者，3193例（0.9%）患者持有医用大麻素证明。在调整分析中，非医用和医用大麻使用均与异丙酚剂量增加（非医用，+6.85 μg kg-1 min-1, 95% CI 6.07-7.63, P-1 min-1, 95% CI 0.88-4.86， P=0.005）和挥发性麻醉剂剂量增加（非医用，+0.01 MAC, 95% CI 0.01-0.02， P-1 min-1异丙酚，95% CI 7.00-9.81, P-1, 95% CI 1.10-1.79， P）相关。结论：大麻使用与异丙酚和挥发性麻醉剂剂量适度升高相关。然而，效应量比以前报道的要小，未来的研究应该调查临床相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

British journal of anaesthesia 医学-麻醉学

CiteScore

13.50

自引率

7.10%

发文量

488

审稿时长

27 days

期刊介绍： The British Journal of Anaesthesia (BJA) is a prestigious publication that covers a wide range of topics in anaesthesia, critical care medicine, pain medicine, and perioperative medicine. It aims to disseminate high-impact original research, spanning fundamental, translational, and clinical sciences, as well as clinical practice, technology, education, and training. Additionally, the journal features review articles, notable case reports, correspondence, and special articles that appeal to a broader audience. The BJA is proudly associated with The Royal College of Anaesthetists, The College of Anaesthesiologists of Ireland, and The Hong Kong College of Anaesthesiologists. This partnership provides members of these esteemed institutions with access to not only the BJA but also its sister publication, BJA Education. It is essential to note that both journals maintain their editorial independence. Overall, the BJA offers a diverse and comprehensive platform for anaesthetists, critical care physicians, pain specialists, and perioperative medicine practitioners to contribute and stay updated with the latest advancements in their respective fields.