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¿Requieren los consumidores de cannabis más anestesia durante la extracción del tercer molar bajo anestesia general

Kanvar S Panesar¹, Charles Smith², Zhehao Zhang³

¹Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Texas Southwestern Medical Center; Former Resident, Department of Oral and Maxillofacial Surgery, University of Washington.

Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons

|February 19, 2026

Resumen

Los consumidores de cannabis pueden requerir más propofol durante la anestesia. Aquellos con 2-3 años de consumo diario de cannabis tienen un alto riesgo de necesitar más anestesia durante la extracción del tercer molar.

Área de la Ciencia:

Anestesiología
Cirugía Oral y Maxilofacial
Farmacología

Sus antecedentes:

Los consumidores de cannabis (CUs) pueden presentar mayores requerimientos de anestésicos generales intravenosos (AGI).
La correlación entre la exposición al cannabis y las necesidades anestésicas sigue sin estar clara.
Este estudio investiga el impacto del consumo de cannabis en la dosificación anestésica.

Objetivo del estudio:

Cuantificar la asociación entre la exposición al cannabis y los miligramos totales de propofol (TMP) administrados.
Estratificar el riesgo de exposición utilizando años de exposición al cannabis (CEYs) y TMP.
Informar el manejo anestésico para CUs sometidos a procedimientos dentales.

Principales métodos:

Estudio prospectivo de 49 sujetos adultos sometidos a extracción de terceros molares (M3) bajo AGI.
La exposición al cannabis se cuantificó mediante CEYs, derivados de la frecuencia y duración.
Se emplearon análisis de regresión multivariante y árboles de decisión para evaluar asociaciones y estratificar el riesgo.

Principales resultados:

Se encontró una asociación significativa entre CEY y TMP después de ajustar por factores de confusión (P = .03).
El análisis de regresión identificó 3 grupos de riesgo: alto riesgo (≥2-3 años, uso diario múltiple), riesgo moderado (>2-3 años, uso infrecuente) y bajo riesgo (<2-3 años, uso infrecuente).
La duración y frecuencia de la exposición al cannabis se correlacionan con mayores requerimientos de propofol.

Conclusiones:

El consumo de cannabis, particularmente ≥2-3 años de sesiones diarias múltiples, se asocia con mayores requerimientos de propofol.
Los pacientes con exposición significativa al cannabis pueden requerir una dosificación anestésica ajustada para la eliminación de M3.
La estratificación del riesgo basada en CEY puede guiar las decisiones clínicas de anestesia.

Palabras clave:

consumo de cannabis anestesia propofol tercer molar extracción anestesia general remover cirugía oral anestesiología

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