⚠️ Cannabis Anesthesia Interaction Perioperative Simulator

Pre-Operative Assessment Includes Cannabis Use History

Placeholder: routine pre-op screening should ask about cannabis use directly.

• ~18%: US adult past-month use (placeholder stat)
• ~1 in 10: Surgical patients using (placeholder stat)
• Yes: Ask directly (reduce stigma, improve accuracy)
• Standardized: Screening tool (placeholder note)

Why disclosure matters

Placeholder: cannabis use affects anesthesia planning across multiple systems.

Placeholder: nonjudgmental questioning improves disclosure rates.

Placeholder: history includes frequency, route, and recency of use.

Regular Cannabis Use and Anesthetic Cross-Tolerance

Placeholder: chronic THC exposure can raise anesthetic dose requirements.

• ~up to 2x: Propofol dose increase (placeholder stat)
• Higher: Opioid requirement (placeholder stat)
• CB1 receptor: Mechanism (placeholder note)
• Slow, monitored: Titration approach (placeholder note)

Dose adjustment considerations

Placeholder: cross-tolerance may require higher induction and maintenance doses.

Placeholder: titrate to effect rather than fixed weight-based dosing.

Placeholder: heavy users show the largest dose shifts.

Airway Hyperreactivity in Chronic Cannabis Smokers

Placeholder: smoked cannabis is linked to airway irritation and reactivity.

• Elevated: Bronchitis symptoms (placeholder stat)
• Increased: Laryngospasm risk (placeholder stat)
• Smoked > edible: Route matters (placeholder note)
• Deeper anesthesia: Airway plan (before instrumentation)

Intubation planning

Placeholder: chronic smoke exposure irritates airway lining.

Placeholder: consider deeper plane before laryngoscopy.

Placeholder: watch for cough, bronchospasm, secretions.

Acute Cannabis Use and Cardiovascular Effects

Placeholder: recent use can cause tachycardia and blood pressure swings.

• +20–50 bpm: Heart rate change (placeholder stat)
• Possible: Orthostatic effect (placeholder stat)
• With vasopressors: Interaction risk (placeholder note)
• Delay elective case: Timing recommendation (if acutely intoxicated)

Hemodynamic monitoring

Placeholder: acute intoxication destabilizes heart rate and pressure.

Placeholder: chronic use may instead blunt sympathetic response.

Placeholder: closer monitoring reduces surprises intraoperatively.

Disclosure and Planning Reduce Perioperative Complications

Placeholder: open disclosure lets the team adjust dosing and timing.

• Lower: Complication rate (with disclosure, placeholder)
• Reduced: Dose surprises (placeholder stat)
• Avoid same-day use: Recommended timing (placeholder note)
• Documented plan: Team communication (placeholder note)

Putting it together

Placeholder: dose adjustment, airway readiness, and CV monitoring combine.

Placeholder: undisclosed use raises risk of intraoperative surprises.

Placeholder: shared decision-making improves safety margins.

Placeholder key insight: disclosed, planned cases trend toward smoother courses.