Department of Anesthesiology, CCM and Pain Relief, Hadassah Hebrew University Hospital.
Bazelet Medical Cannabis Group, Israel.
Curr Opin Anaesthesiol. 2020 Dec;33(6):832-840. doi: 10.1097/ACO.0000000000000932.
Growing numbers of patients, consuming cannabinoids admitted to surgery, create a challenge to anesthesia providers. This review provides a summary of recent literature related to cannabis and anesthesia, with specific recommendations to the anesthetic management of medical cannabis consumers.
At present, cannabis has found its way to public consensus in many countries and is penetrating slower to different medical fields. We relate and discuss recent findings investigating effects of cannabis consumption on the various aspects including perioperative measures, post-operative pain, PONV, cardiovascular stability, and anesthesia monitoring.
Recent surveys estimate that 10-20% of adult populations have consumed cannabis in the past year. Medical cannabis consumers are a newer group of cannabis users. Anesthesia providers have to update their knowledge on cannabis and possible anesthetic interaction. It is unreasonable to make recommendations that apply to the whole heterogeneous group of cannabis users, but is easier with the more homogenous group of Medical cannabis users, characterized by frequent use and relatively high cannabis doses, combined with good knowledge of administered composition and protocol, as well as adverse and withdrawal effects. Anesthesia providers have to know the effects and modify anesthetic plan accordingly. We provide perioperative anesthetic recommendations related to medical cannabis consumers. Collecting information of the effects of medical cannabis use in perioperative setting will further create a highly useful database for anesthetics in the close future.
越来越多的使用大麻素的患者接受手术，这给麻醉提供者带来了挑战。本文综述了与大麻和麻醉相关的最新文献，为医用大麻使用者的麻醉管理提供了具体建议。
目前，大麻已在许多国家得到公众认可，并逐渐渗透到不同的医学领域。我们调查了大麻消费对包括围手术期措施、术后疼痛、术后恶心呕吐、心血管稳定性和麻醉监测在内的各个方面的影响，并对这些发现进行了讨论。
最近的调查估计，10-20%的成年人口在过去一年中使用过大麻。医用大麻使用者是大麻使用者中的一个较新群体。麻醉提供者必须更新他们对大麻和可能的麻醉相互作用的知识。对整个异质的大麻使用者群体提出建议是不合理的，但对于更同质的医用大麻使用者群体来说，情况就容易一些，这些医用大麻使用者的特点是经常使用且大麻剂量相对较高，同时对所使用的成分和方案有较好的了解，以及对不良反应和戒断症状的了解。麻醉提供者必须了解其作用并相应地修改麻醉计划。我们提供了与医用大麻使用者相关的围手术期麻醉建议。在围手术期环境中收集医用大麻使用效果的信息，将在不久的将来进一步为麻醉学创造一个非常有用的数据库。
