is the Lead CRNA at East Bay Endosurgery Center, Oakland, California, and Chief CRNA at Tri-Valley Stanford Health, Pleasanton, California-Obstetrics. Email:
is an Associate Clinical Professor at University California San Francisco Doctor of Nursing Practice (DNP) Doctoral program, San Francisco, California. Email:
AANA J. 2024 Apr;92(2):121-130.
Although some researchers have reported health-related benefits of marijuana, others have reported adverse side effects in nearly every organ system. Patterns of marijuana use are evolving, as is researchers' understanding of marijuana use for healthcare. Despite these findings and developments, nurse anesthetists are inadequately educated about marijuana's perioperative effects on endosurgical patients. As a result, many nurse anesthetists lack confidence in and knowledge of the perioperative care of endosurgical patients under the influence of marijuana. This lack of confidence and knowledge limits the ability of nurse anesthetists to provide optimal care, threatens patient safety, and potentially impairs surgical outcomes. To improve the confidence and perceived knowledge of certified registered nurse anesthetists (CRNAs) regarding perioperative care of endosurgical patients who use marijuana, a quality improvement project was conducted in a metropolitan endosurgical center in California. After the project, participating CRNAs (N = 15) reported increased confidence ( = -0.982; = .325, > .05) and significantly improved perceived knowledge ( = -3.04; = .002, < .05) regarding care of patients who use marijuana. For endosurgical patients who used marijuana prior to their procedure, knowledgeable and confident anesthesia care for the side effects of marijuana substantially improved the quality of care, communication, and reduced cancellations.
虽然一些研究人员报告了大麻与健康相关的益处，但也有其他研究人员报告了几乎每个器官系统都存在的不良反应。大麻的使用模式在不断变化，研究人员对大麻在医疗保健中的使用的理解也在不断变化。尽管有这些发现和进展，但护士麻醉师对大麻对内镜手术患者围手术期影响的了解仍然不足。因此，许多护士麻醉师对大麻影响下内镜手术患者的围手术期护理缺乏信心和了解。这种缺乏信心和知识限制了护士麻醉师提供最佳护理的能力，威胁患者安全，并可能影响手术结果。为了提高注册护士麻醉师（CRNA）对使用大麻的内镜手术患者围手术期护理的信心和感知知识，在加利福尼亚州的一家都市内镜中心进行了一项质量改进项目。在项目之后，参与的 CRNA（N=15）报告说，他们对护理使用大麻的患者的信心（= -0.982；=.325，>.05）有所提高，对护理知识的感知（= -3.04；=.002，<.05）有显著提高。对于在手术前使用大麻的内镜手术患者，有知识和信心的麻醉护理可以显著改善副作用的护理质量、沟通，并减少取消手术的情况。
