Implications of marijuana use prior to anesthetic care.

Abstract

Marijuana is classified as a Schedule I substance by the Drug Enforcement Administration (DEA). In recent years, many states have chosen to legalize marijuana for medical purposes. However, marijuana remains one of the most commonly abused illicit substances in the United States with the highest prevalence of use occur- ring in adolescents and young adults. The continued widespread use of marijuana increases the likelihood that patients may present for medical or anesthetic care while intoxicated. Although there is extensive literature per- taining to the pharmacology of marijuana and its end-or- gan effects, our current understanding of the interactions between marijuana and anesthetic agents is limited. We present a 16-year-old adolescent who had a recent history of marijuana use the morning prior to surgery. The phys- iologic end-organ effects of marijuana are reviewed, its potential interaction with intraoperative anesthetic care presented, and options for anesthetic care discussed.

Keywords

• marijuana
• cannabinoids
• tetrahydrocannabinol (thc)
• cannabidiol (cbd)