Anesthesia for Patients Who Self-Report Cannabis (Marijuana) Use Before Esophagogastroduodenoscopy: A Retrospective Review.
Daniel D King, Scott A Stewart, Angela Collins-Yoder and 2 others
PMID 34042571WHAT IT FOUND
Patients who self-reported cannabis use before an endoscopy did not require significantly more propofol than non-users.
The study was too small to detect real differences, so clinicians should not assume cannabis users need higher anesthetic doses based on this paper.
Key findings
01There were no significant differences in the total amount of propofol administered between cannabis users and non-users.
02Adjusting propofol dose for patient weight and procedure duration also showed no significant differences between the groups.
03No adverse cardiac or respiratory events were reported for either group during the procedure or within 30 days after.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study included only 23 matched pairs, making it underpowered to detect small but clinically relevant differences. Cannabis use was self-reported and often lacked details on dose, route, or frequency, leading to potential misclassification. The study excluded patients with other substance abuse or liver impairment, limiting generalizability to complex patients. There was no prior power analysis, and the authors acknowledged the sample size was too small to draw definitive conclusions. Patient satisfaction data was incomplete, with nearly half of the calls unanswered or records missing.
Declared interests
No specific funding or conflict of interest declarations were provided in the supplied text.
The easy way to misread this
Do not interpret the lack of significant difference in propofol dose as proof that cannabis use never affects anesthetic requirements. The study was underpowered with only 23 participants per group, so a real but modest increase in dose could easily have been missed.