RT Journal Article
SR Electronic
T1 ASRA Pain Medicine consensus guidelines on the management of the perioperative patient on cannabis and cannabinoids
JF Regional Anesthesia & Pain Medicine
JO Reg Anesth Pain Med
FD BMJ Publishing Group Ltd
SP rapm-2022-104013
DO 10.1136/rapm-2022-104013
A1 Shalini Shah
A1 Eric S Schwenk
A1 Rakesh V Sondekoppam
A1 Hance Clarke
A1 Mark Zakowski
A1 Rachel S Rzasa-Lynn
A1 Brent Yeung
A1 Kate Nicholson
A1 Gary Schwartz
A1 W Michael Hooten
A1 Mark Wallace
A1 Eugene R Viscusi
A1 Samer Narouze
YR 2023
UL http://rapm.bmj.com/content/early/2023/01/05/rapm-2022-104013.abstract
AB Background The past two decades have seen an increase in cannabis use due to both regulatory changes and an interest in potential therapeutic effects of the substance, yet many aspects of the substance and their health implications remain controversial or unclear.Methods In November 2020, the American Society of Regional Anesthesia and Pain Medicine charged the Cannabis Working Group to develop guidelines for the perioperative use of cannabis. The Perioperative Use of Cannabis and Cannabinoids Guidelines Committee was charged with drafting responses to the nine key questions using a modified Delphi method with the overall goal of producing a document focused on the safe management of surgical patients using cannabinoids. A consensus recommendation required ≥75% agreement.Results Nine questions were selected, with 100% consensus achieved on third-round voting. Topics addressed included perioperative screening, postponement of elective surgery, concomitant use of opioid and cannabis perioperatively, implications for parturients, adjustment in anesthetic and analgesics intraoperatively, postoperative monitoring, cannabis use disorder, and postoperative concerns. Surgical patients using cannabinoids are at potential increased risk for negative perioperative outcomes.Conclusions Specific clinical recommendations for perioperative management of cannabis and cannabinoids were successfully created.Data such as group vote tallies and comments on each Delphi round are available upon request.