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Is Smoking Cannabis Before Surgery Dangerous?

Saturday November 10, 2018

T here is pretty much nothing more anxiety-inducing than getting surgery that requires anesthesia. “I’ll just smoke a little marijuana beforehand,” you might reason, “to calm myself down.” Stop right there. Consuming cannabis before surgery can put you at a higher risk for complications both during and after the procedure. To help you stay safe during an operation, here’s everything you need to know about cannabis and surgery.

What’s the Deal with Cannabis and Anesthesia

Cannabis has a tendency to lower blood pressure and raise heart rate. This will likely interact poorly with anesthesia, which has a tendency to do the same thing, thereby attenuating the effects of anesthesia. This results in being under longer and makes waking up more difficult.

Smoking cannabis also causes an increase in sputum, and smokers have an overactive airway, which can cause coughing and lead to aspiration during and after surgery.

Coughing post-op could also cause internal bleeding and hematomas. And for those who have hypertension, the combination of anesthesia, cannabis and hypertension medicines could potentially lead to hypotension, or abnormally low blood pressure. Additionally, there is carbon monoxide in cannabis smoke, which inhibits blood oxygenation and decreases blood flow, which could lead to tissue death, more scarring and slower wound healing. And, if you smoke marijuana, you are more likely than your non-smoking counterparts to be on a ventilator and developing a nasty complication like pneumonia.

Another complication comes along with the anesthetic. Research shows that a propofol, a frequently used anesthetic, must be administered in higher doses to smokers of all kinds, not just marijuana smokers.

If You Just Can’t Go Without Cannabis

Of course, when it comes to a definitive answer on whether consuming cannabis before surgery is acceptable, there are several variables that come into play – making it difficult to provide a simple yes or no answer. Ultimately, if you can go without consuming before your operation that’s probably the safest play, however, if you feel you can’t take a break from your cannabis habits, consider following the tips found in this section.

Co-founder of the American Academy of Cannabinoid Medicine, clinical expert, and author of Drugs Are Not The Devil’s Tools, Dr. David Bearman, recommends not smoking for at least several hours before surgery.

He says that most patients arrive for surgery around three hours before their scheduled time, and the effects of cannabis, depending on potency, typically last around one and a half to two and a half hours. Not smoking cannabis in that three hour window of time will also help clear sputum. Even better, add cannabis to the prescribed, pre-surgery doctor fast, usually no food or drink after 10:00 pm the night before a procedure.

To put cannabis use in the lower risk category, bypass smoking altogether and stick with a non-combustible method, like tinctures or edibles. This does not add to sputum production, but it does have a more variable effect on the body. Knowing how long it will remain in your system, potentially affecting blood pressure and heart rate, is important not only for you, but especially for the anesthesiologist.

Post-Op Information

It has long been known that cannabis can help reduce pain and reduce the reliance on more dangerous post-operative drugs like opioids. However, if the procedure involved the abdominal area, for example, smoking cannabis can cause coughing, which can the stitches quite literally keeping you together. Once again, using cannabis via an intake route other than smoking would definitely be the more prudent way to go.

Full Disclosure

Regardless of how much marijuana you consume by whatever method, it is important to be upfront with your doctor about your cannabis history. This will allow the anesthesiologist to be on the lookout for any potential complications, and your medical team can direct your course of care more clearly. Not disclosing your cannabis use can literally put you in danger during surgery, so spill the beans.

To really protect yourself before surgery, the safest route would be to stop consuming altogether – that includes tobacco – for four to six weeks beforehand.

Have experience with cannabis consumption and surgery? Share your feedback in the comments below!

Even though cannabis might be a great way to combat pre-operation anxiety, smoking marijuana before surgery can cause unwanted complications. Find out if its safe to consume cannabis before surgery and what products might be the best choice.

How Marijuana Can Affect Your Surgery

Scott Sundick, MD, is a board-certified vascular and endovascular surgeon. He currently practices in Westfield, New Jersey.

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If you smoke marijuana and are planning to have surgery you may be wondering if you need to stop smoking before your procedure. Like smoking cigarettes, the short answer is this: Yes, quitting today may improve your surgical outcome, how quickly you get out of the hospital, and how quickly you heal after surgery.

Marijuana Before Surgery

Like nicotine, marijuana can complicate surgery and should be avoided in the weeks and even months prior to your procedure. Much like smoking cigarettes, abstaining from marijuana in the weeks before surgery can decrease the likelihood of complications during and after surgery.

Unfortunately, research on the topic of marijuana use and the effects during surgery is limited. It should become more plentiful in the future as medicinal marijuana has been legalized in multiple states (and recreational use in a growing number), making it easier to gather scientific data on the topic.

We do know that marijuana, while effective for decreasing nausea and some other health-related benefits, has the potential to interact with anesthesia.  

Risks of Smoking Marijuana

Contrary to popular wisdom, marijuana smoking is not a healthier option than cigarettes. It can lead to lung cancer and other respiratory problems.  

The process of inhaling large amounts of marijuana, then holding it in the lungs for extended periods of time to increase the amount absorbed, leads to increased exposure to cancer-causing chemicals.

The chronic coughing, wheezing and difficulty breathing that long-term cigarette smokers experience also occur in marijuana users.  

Types of Marijuana

When talking about surgery anesthesia and marijuana, all types of marijuana should be avoided. That means smoking marijuana, edibles, and synthetic marijuana.

Synthetic marijuana, in particular, is poorly understood, unregulated, and highly variable in content. For this reason, it is impossible to predict the reaction that might occur with exposure to anesthesia. Synthetic marijuana should not be used in the days, or even weeks, prior to surgery.

Marijuana and Anesthesia

Smoking marijuana regularly leads to the same risks of complications faced by patients who smoke cigarettes. This means that marijuana smokers are more likely than non-smokers to be on the ventilator longer, have a higher risk of developing pneumonia after surgery, and greater scarring of incisions.

The use of marijuana, especially immediately prior to surgery, can change the doses needed for sedation.   One commonly used medication, propofol, requires substantially higher doses for the patient who routinely uses marijuana.

One study looked at the doses of propofol required to intubate patients who routinely smoked marijuana with non-marijuana using patients.   The individuals who used marijuana required a dramatic increase in sedation.

One patient who smoked marijuana 4 hours prior to surgery was the topic of a case study, after experiencing an airway obstruction during the procedure.   This is a very serious complication that can lead to death, and is believed to have been caused by airway hyperreactivity, a condition known in cigarette smokers but previously unidentified in marijuana users.

It is also believed that regular users of marijuana—whether it is smoked or eaten—are more likely to experience agitation.

Marijuana Effects During Surgery

The use of marijuana the day before surgery, and especially in the hours prior to the procedure, can cause more dramatic effects.   While some people are tempted to use marijuana prior to surgery in an effort to relax or be less stressed before the procedure, this is a very bad idea and can cause problems.

Marijuana causes the blood vessels of the body to relax, a process called vasodilation. This process can cause the blood pressure to fall and the heart rate to increase. These, in turn, can complicate matters if the patient’s blood pressure is falling due to issues with the surgery, and can change the way the body responds to anesthesia.

Tell the Truth About Marijuana Use

It is very important that you are candid with the anesthesia provider about your personal use of marijuana. This means giving an accurate report of how much and how often you use marijuana, whether you eat it or smoke it, and when you last did so.

It is unlikely that your use will delay your surgery, but it is important that the anesthesia provider understands the potential for your body to need more anesthetic than is typical.

The anesthesia provider also needs to be prepared for any airway issues that may arise, which are more common in smokers of all types compared to non-smokers.

After Surgery

Regular marijuana use, like cigarette and cigar use, can increase the length of time it takes to be removed from the ventilator after surgery.   The risk of being on the ventilator long term is decreased by quitting smoking before surgery, and that risk is decreased further with every day that passes between the last day of smoking and the day of surgery.

A Word From Verywell

It may seem like a drag—pardon the pun—to stop smoking marijuana before surgery and to not smoke during your recovery from surgery, but you will heal faster, return to your normal activities more quickly, have less scarring and fewer complications if you refrain.

It is true that most people would have quit smoking long ago if it were easy, but surgery offers a real incentive to back away from the marijuana (and nicotine) in order to have the best possible outcome after surgery.

Every day you go without smoking prior to surgery will decrease your chances of being on the ventilator longer than the average patient, and will decrease the length of your stay in the hospital.

Smoking pot before surgery can cause problems during and after your procedure, find out why you should avoid marijuana before surgery. ]]>