Marijuana use linked to surgical complications

Marijuana use linked to surgical complications

The Impact of Marijuana Use on Surgical Complications

Marijuana use has become increasingly prevalent in recent years, and with its legalization in many parts of the world, its impact on various aspects of health is being closely examined. A new study suggests that regular marijuana use may increase the risk of complications during and after surgery, highlighting the importance for doctors to address this when planning operations.

The study, conducted by researchers at the University of Texas McGovern Medical School in Houston, found that people with a cannabis use disorder are 20% more likely to experience serious complications, such as stroke or blood clots, after a major operation compared to patients who do not depend on marijuana. Although the effect is not huge, it is significant enough to warrant attention from patients and healthcare professionals.

Dr. Paul Potnuru, the lead researcher of the study, emphasizes the need for doctors to be aware of their patients’ cannabis use and its frequency. He suggests that heavy or excessive use of marijuana can have negative impacts on surgical outcomes. Cannabis use disorder, as defined by the study, refers to the continued excessive use of marijuana despite its adverse effects on health, social life, or work performance. According to the U.S. National Institute on Drug Abuse, over 16 million Americans had a cannabis use disorder in 2021.

While the study establishes an association between marijuana use disorder and surgical complications, it does not prove causation. However, there may be a biological basis for this association. The psychoactive substance in cannabis, THC, has the potential to cause blood vessels to spasm, leading to heart attacks or strokes. Additionally, THC can suppress the immune system, further increasing the risk of complications.

The question of whether patients should cease marijuana use before major elective surgery remains unanswered. Dr. Potnuru likens it to smoking tobacco, where it is generally better to stop heavy usage, especially before surgery. He believes that marijuana’s impact on surgical outcomes is significant enough to warrant attention and consideration.

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In light of these findings, the American Society of Regional Anesthesia (ASRA) and Pain Medicine have released guidelines advising anesthesiologists to screen all patients for cannabis use before surgery. Patients should be informed about the increased risk of adverse outcomes associated with marijuana use. This proactive approach allows healthcare professionals to adjust anesthesia plans or possibly delay procedures based on patients’ cannabis use.

For the study, Dr. Potnuru’s team analyzed data from over 62,000 hospitalizations for major elective surgeries performed between 2016 and 2019. Out of these patients, 6,211 had cannabis use disorder, while 6,211 did not. The researchers discovered that patients with cannabis use disorder had higher risks of various complications, including heart attack, stroke, kidney problems, respiratory failure, blood clots, hospital-acquired infections, and additional surgical procedures related to complications. Their hospital stays were also more costly due to additional treatments and medications required to manage surgical complications.

Despite these findings, not everyone agrees with the conclusions drawn by Dr. Potnuru and his team. Dr. Peter Grinspoon, a cannabis specialist at Massachusetts General Hospital and Harvard Medical School, offers a differing perspective. He argues that the study’s definition of cannabis use disorder and its supposed link with surgical complications require further scrutiny. Dr. Grinspoon believes that the existing definition of “cannabis addiction” is flawed and inflated, as it fails to differentiate between addicted users and casual users in many electronic medical record systems. Consequently, he questions the validity of the dataset and suggests that the study does not prove causation between cannabis use and surgical complications.

Dr. Grinspoon further argues that quizzing patients about their marijuana use places an unnecessary burden on doctors. He believes that healthcare professionals should prioritize risk stratification for more well-established factors such as alcohol, tobacco, blood pressure, and exercise tolerance, rather than focusing on unproven associations. While understanding the potential harms and benefits of marijuana is crucial, Dr. Grinspoon suggests that this particular study does not contribute significantly in that regard.

In conclusion, the study conducted by Dr. Potnuru and his team adds to the growing body of research on the impact of marijuana use on health outcomes. While it establishes an association between cannabis use disorder and surgical complications, further investigation is necessary to prove causation. Nevertheless, the study highlights the importance of discussing cannabis use with patients before surgery, allowing healthcare professionals to make informed decisions in order to minimize risks and optimize outcomes for their patients.

[ASRA]: American Society of Regional Anesthesia [THC]: Tetrahydrocannabinol