Small study shows cannabis users need more anesthesia

[sprorchid]

I have a colonoscopy tomorrow, so this may come into play for me:

https://www.cnn.com/2019/04/15/health/cannabis-anesthesia-study/index.html

 

[Climber]

Probably true for all drug users.

Alternatively, people who don't drink or use drugs are probably getting over-sedated because the average dose probably takes into account for people drinking or using drugs.

 

[Blankpage]

Do you need anesthetized for a colonoscopy. I had an endoscopy a year ago and was alert throughout the procedure. It was no big deal.
They give you a mild sedative.

 

[bruceflinch]

I have a colonoscopy tomorrow, so this may come into play for me:

https://www.cnn.com/2019/04/15/health/cannabis-anesthesia-study/index.html

Not surprised, but interesting.

I hope you cut beef out of your diet for the past few weeks. The “clean out” today would be much easier.

I’ve had 3 of those procedures and the anesthesia was different for all three.

Good luck!

 

[Climber]

Do you need anesthetized for a colonoscopy. I had an endoscopy a year ago and was alert throughout the procedure. It was no big deal.
They give you a mild sedative.

I've had them both ways and will take asleep over getting an ice cold giant metal device getting pushed up my rectum for what feels like several feet any day.

Perhaps some people enjoy it.

 

[mean dad]

Probably true for all drug users.

Alternatively, people who don't drink or use drugs are probably getting over-sedated because the average dose probably takes into account for people drinking or using drugs.

wat.

 

[bruceflinch]

I've had them both ways and will take asleep over getting an ice cold giant metal device getting pushed up my rectum for what feels like several feet any day.

Perhaps some people enjoy it.

They say 1 out of 4 people suffer from diarrhea. Do 3 out of 4 enjoy it?

 

[Junkie]

when I had my cardiac cath they had to keep giving me more and more and more of the fentanyl/versed

it was supposed to be conscious sedation, from what they said I didn't end up all that conscious

but that may have been due to a reaction to the epinephrine

 

[Climber]

wat.

If the majority of the population drinks or does drugs to some degree, wouldn't it follow that the average (baseline) dose would be impacted by that?

it's just an extension of what they're saying from this study. I'm guessing (possibly wrong) that any kind of substance that alters your perception (drugs, alcohol) and is used regularly by somebody could impact the dose necessary to anesthetize you.

 

[NorCalAthlete]

Pretty sure anesthesiologists account for drug / no drug / whatever drug / alcohol / etc usage when figuring out what and how much to give you. It's kinda their job to not depend on any average baseline and do everything on a case by case basis.

OTOH it's a very strong argument for "be honest with your doctors, they're not the ones who are going to worry about arresting you, but it can literally be life threatening to lie to them."

 

[Climber]

Pretty sure anesthesiologists account for drug / no drug / whatever drug / alcohol / etc usage when figuring out what and how much to give you. It's kinda their job to not depend on any average baseline and do everything on a case by case basis.

OTOH it's a very strong argument for "be honest with your doctors, they're not the ones who are going to worry about arresting you, but it can literally be life threatening to lie to them."

Good points.

They have to have a starting point (baseline) and go from there, depending on all of the known factors. Very good point on being honest with what you put in your body on a regular basis. Also, some people just have a genetic pre-disposition to be more sensitive to anesthesia. My dad and sister are two.

 

[Yakoo752]

Pretty sure anesthesiologists account for drug / no drug / whatever drug / alcohol / etc usage when figuring out what and how much to give you. It's kinda their job to not depend on any average baseline and do everything on a case by case basis.

OTOH it's a very strong argument for "be honest with your doctors, they're not the ones who are going to worry about arresting you, but it can literally be life threatening to lie to them."

They push based on body weight ranges but monitor how it's impacting the patient. There is never a 1:1 mix as it can vary wildly per patient. Like you said, their job is not about baselines and it's to treat every patient as unique.

This is just an indication that on average, people who consume marijuana tend to need more.

If you were to tell your Dr you smoke a # a day, it wouldn't change the anest. procedure 1 bit.

 

[Junkie]

Pretty sure anesthesiologists account for drug / no drug / whatever drug / alcohol / etc usage when figuring out what and how much to give you. It's kinda their job to not depend on any average baseline and do everything on a case by case basis.

OTOH it's a very strong argument for "be honest with your doctors, they're not the ones who are going to worry about arresting you, but it can literally be life threatening to lie to them."

and yet people who do use drugs might be hesitant to tell their doctors, because it could result in notes on their record to limit what's given to them

 

[Climber]

They push based on body weight ranges but monitor how it's impacting the patient. There is never a 1:1 mix as it can vary wildly per patient. Like you said, their job is not about baselines and it's to treat every patient as unique.

This is just an indication that on average, people who consume marijuana tend to need more.

If you were to tell your Dr you smoke a # a day, it wouldn't change the anest. procedure 1 bit.

They are going to need a starting point based upon data gathered for all of the factors. The, yes they adjust from there depending on how the patient is responding. The baseline isn't an average for everybody, it's a baseline for their weight, health and other factors.

 

[Yakoo752]

They are going to need a starting point based upon data gathered for all of the factors. The, yes they adjust from there depending on how the patient is responding. The baseline isn't an average for everybody, it's a baseline for their weight, health and other factors.

I help design and develop workflows for anesthesiologist...

Part of the design is to monitor how much of an opiod is prescribed and used/wasted in theater.

I have intimate knowledge in this space

please tell me more about how it all works.

 

[Climber]

I help design and develop workflows for anesthesiologist...

Part of the design is to monitor how much of an opiod is prescribed and used/wasted in theater.

I have intimate knowledge in this space

please tell me more about how it all works.

Ok, then please explain how they arrive at the dosage they start at with a patient?

 

[Yakoo752]

Which medication? Because they can all differ on requirements. Are you talking general or local/regional? Sedatives or memory blocks?

Our system and workflow take into account for age, weight, and gender. It also accounts for medications, prior complications, and medical history.

Then the anesth continually monitors for heart rate and rhythm, blood pressure, body temp, breathing rate or pattern, oxygen and carbon dioxide levels, along with exhaled anesthetic concentration and adjusts accordingly.

Everyone is unique. I never said don't tell your Doc but it's not going to change first dose until there is an established procedure to support it.

If I came off as dickish early, sorry. Busy Monday morning already.

 

[Climber]

Which medication? Because they can all differ on requirements.

Our system and workflow take into account for age, weight, and gender. It also accounts for medications, prior complications, and medical history.

Then the anesth continually monitors for heart rate and rhythm, blood pressure, body temp, breathing rate or pattern, oxygen and carbon dioxide levels, along with exhaled anesthetic concentration and adjusts accordingly.

Everyone is unique. I never said don't tell your Doc but it's not going to change first dose until there is an established procedure to support it.

If I came off as dickish early, sorry. Busy Monday morning already.

I would assume that there are tables (or now programs or spreadsheets) that the anesthesiologist put in the information they get from the patient with all of those factors, then end up with a dosage to start with. That starting could also include adjustments from their experience, that puts them at a starting point that then gets adjusted as the patient responds in one direction or another as they're being administered their anesthesia.

I probably I could have been more specific with my term of baseline, I was thinking in terms of a starting point from all of the factors for each patient arrived at through data from numerous patients which would then get further refined by the anesthesiologists experience, patient history, etc.

 

[Yakoo752]

I would assume that there are tables (or now programs or spreadsheets) that the anesthesiologist put in the information they get from the patient with all of those factors, then end up with a dosage to start with. That starting could also include adjustments from their experience, that puts them at a starting point that then gets adjusted as the patient responds in one direction or another as they're being administered their anesthesia.

I probably I could have been more specific with my term of baseline, I was thinking in terms of a starting point from all of the factors for each patient arrived at through data from numerous patients which would then get further refined by the anesthesiologists experience, patient history, etc.

pretty much so. It's all data driven today and driven by simple algorithms.

The 3 key metrics used are age, weight, gender to determine first dose. All the rest of the metrics are used to determine how much more to give a patient. It's always better to give to little than too much. Once a Dr determines how that's impacting the patient, they move forward with more. A lot of this is done in pre-op where anti anxiety and antiemitic are given.

personal note. It takes a lot to put me out. The last time, the Dr gave a first dose and left. Came back to check and bumped me up twice. As he filled the next syringe, he was very clear that I was donezo after this round. Had me count back from 10 and I was eyes open at 1. Had me start counting up and night night I went by #3. I took just under twice the amount it takes to put down someone my height and weight. Zero stress during the procedure with the exception that they accidentally broke and then had to wire my jaw shut which put my heart rate through the roof. (reasoning for the large dose requirement... my metabolism was through the roof at the time as I was doing SEAL PT every morning while preparing for SWIM School)

 

[mean dad]

If the majority of the population drinks or does drugs to some degree, wouldn't it follow that the average (baseline) dose would be impacted by that?

it's just an extension of what they're saying from this study. I'm guessing (possibly wrong) that any kind of substance that alters your perception (drugs, alcohol) and is used regularly by somebody could impact the dose necessary to anesthetize you.

I'm going to go out on a limb and say it's more precise than that; but I am not an anesthesiologist, nor did I stay at a Holiday Inn Express last night so...

Edit: Yakoo says we're both kinda right.