AuthorsJeffrey Cashin, M.D. Kevin Dewalt, M.D.Affiliated institution: Harbor UCLA Medical CenterBackground: In America, the use of recreational and medical marijuana is at an all-time high. According to the NIH, the... [ view full abstract ]
Authors
Jeffrey Cashin, M.D. Kevin Dewalt, M.D.
Affiliated institution:
Harbor UCLA Medical Center
Background:
In America, the use of recreational and medical marijuana is at an all-time high. According to the NIH, the percentage of Americans who reported using marijuana more than doubled between 2002 and 2012. For many anesthesiologists, anesthetizing patients with urine toxicology screens positive for marijuana is an increasingly common occurrence. Despite this, there are profound gaps in our knowledge as to the effects of marijuana on our anesthetics.
Methods:
All ORIF mandible cases performed from 11/1/2014-03/01/2017 at Harbor UCLA Medical Center in Torrance, California (HUMC) were retrospectively analyzed. Due to the prevalence of cocaine and methamphetamine use in the patient population who suffer mandibular fractures, many anesthesia providers obtain urine toxicology screens the day of surgery. The implementation of an electronic medical record and electronic intraoperative documentation system at HUMC enabled us to sort patients according to toxicology results and to track multiple intraoperative metrics. These results were compared to a control group, who had negative toxicology screens and denied using marijuana.
Results:
Based on our preliminary data analysis, patients with positive urine toxicology screens for marijuana require additional intravenous anesthetics on induction. Additional metrics (e.g. total narcotics given, narcotics given within one hour of induction or emergence, narcotics given in PACU are still being analyzed).
Conclusions:
Based on the increasing prevalence of marijuana use in the United States, anesthesia providers can expect to encounter marijuana-positive patients with increasing regularity. It is critical that these providers have an understanding of the effects of marijuana on our anesthetic medications. Our retrospective analysis is a small step toward increasing our understanding. Certainly, more research is needed into the effects of marijuana on our anesthesia practice.
