Outpatient Surgery Magazine

Backbreaker - April 2019 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 25 of 146

macologic implications. 1. Higher doses of sedatives. Be aware of patients who use marijua- na as a self-prescribed sedative before surgery. The use of marijuana, especially immediately before surgery, can change the doses you'll need for sedation. A study (osmag.net/BF6kwN) in the March 2009 European Journal of Anaesthesiology found that patients who rou- tinely use marijuana will require substantially higher doses of propo- fol for satisfactory clinical induction when inserting a laryngeal mask. 2. Vasodilation. Just like anesthesia, cannabis has a tendency to lower both blood pressure and heart rate. This will attenuate the effects of anesthesia, resulting in patients being under longer and having a hard- er time waking up. 3. Airway obstruction. Just like a nicotine smoker, pot smokers have an overactive airway, which can cause coughing and lead to aspiration during and after surgery. Smoking marijuana before surgery also increases mucus production in the respiratory tract. 4. Drowsiness. Marijuana might increase the amount of drowsiness some drugs cause. Examples include benzodiazepines such as lorazepam (Ativan) or diazepam (Valium), barbiturates such as pheno- barbital, narcotics such as codeine, some antidepressants and alcohol. 5. Increased risk of bleeding. Marijuana may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin) or heparin, antiplatelet drugs such as clopido- Safety S 2 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A P R I L 2 0 1 9

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