Do Cannabis Users Require More Anesthesia During Third Molar Removal Under Intravenous General Anesthesia When...

Area of Science:

• Anesthesiology
• Oral and Maxillofacial Surgery
• Pharmacology

Background:

• Cannabis users (CUs) may exhibit increased requirements for intravenous general anesthetic (IVGA).
• The correlation between cannabis exposure and anesthetic needs remains unclear.
• This study investigates the impact of cannabis use on anesthetic dosing.

Purpose of the Study:

• To quantify the association between cannabis exposure and total milligrams of propofol (TMP) administered.
• To stratify exposure risk using cannabis exposure years (CEYs) and TMP.
• To inform anesthetic management for CUs undergoing dental procedures.

Main Methods:

• Prospective study of 49 adult subjects undergoing third molar (M3) removal under IVGA.
• Cannabis exposure was quantified by CEYs, derived from frequency and duration.
• Multivariate regression and decision tree analysis were employed to assess associations and stratify risk.

Main Results:

• A significant association was found between CEY and TMP after adjusting for confounders (P = .03).
• Regression analysis identified 3 risk groups: high risk (≥2-3 years, multiple daily use), moderate risk (>2-3 years, infrequent use), and low risk (<2-3 years, infrequent use).
• Cannabis exposure duration and frequency correlate with increased propofol requirements.

Conclusions:

• Cannabis use, particularly ≥2-3 years of multiple daily sessions, is associated with higher propofol requirements.
• Patients with significant cannabis exposure may require adjusted anesthetic dosing for M3 removal.
• Risk stratification based on CEY can guide clinical anesthetic decisions.