New guidelines released last week by the American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine) recommend that all patients should be screened for cannabis use prior to surgery as studies have shown that regular cannabis consumers often have more pain and nausea after surgery.
The guidelines are the first issued by ASRA Pain Medicine related to cannabis consumers and surgery. The guidelines recommend anesthesiologists screen all patients for cannabis consumption, including asking about the type of cannabis product consumed, the amount and how it was consumed or used, how recently it was consumed, and at what frequency.
In a press release, Samer Narouze, MD, PhD, ASRA Pain Medicine president, said prior to surgery “anesthesiologists should ask patients if they use cannabis – whether medicinally or recreationally – and be prepared to possibly change the anesthesia plan or delay the procedure in certain situations.”
“They also need to counsel patients about the possible risks and effects of cannabis. For example, even though some people use cannabis therapeutically to help relieve pain, studies have shown regular users may have more pain and nausea after surgery, not less, and may need more medications, including opioids, to manage the discomfort. We hope the guidelines will serve as roadmap to help better care for patients who use cannabis and need surgery.” — Narouze in a statement
The guidelines are based on a literature review and experiences from the organization’s “Perioperative Use of Cannabis and Cannabinoids Guidelines Committee,” which is comprised of 13 experts, including anesthesiologists, chronic pain physicians, and a patient advocate.
The organization also released an infographic to explain the methodology or recommendations for the management of perioperative patients who consume cannabis.
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