Cannabis and THC may have an effect on reducing the effectiveness of anesthetics used in hair transplants and other anesthetic procedures. This observation has been made by many hair transplant surgeons and substantiated by Anesthesiologists and the peer-reviewed article below.

A review of the anesthetic implications of marijuana use

Conclusion of the article: Anesthesiologists should query patients on the use of cannabis products during the preoperative evaluation, particularly if evidence of acute intoxication or withdrawal is present. Specific attention should be paid to the most recent use as well as the overall duration and frequency of use. In addition, anesthesiologists should inquire about the type of cannabis product used and the route of ingestion. These questions will help gauge the potential for acute intoxication, tolerance, or withdrawal. Clinical history and examination with pointed questions will be more important than quantitative factors such as toxicology screens, given the limitations of current toxicology screening methods for cannabis products due to the unique pharmacokinetics of cannabis metabolism and elimination. As use of highly potent cannabis products grows more common, patients may more commonly present with an altered sensorium that precludes the ability to query about cannabis use. Thus, when the anesthesiologist is called to care for patients with such a constellation of symptoms, a high index of suspicion and consideration of acute cannabis intoxication in the differential diagnosis may guide care of these patients.

John C. Alexander, MD, MBA and Girish P. Joshi, MD, MBBS

Author information Article notes Copyright and License information

Proc (Bayl Univ Med Cent). 2019 Jul; 32(3): 364–371.

Published online 2019 May 21. doi: 10.1080/08998280.2019.1603034

PMCID: PMC6650211

PMID: 31384188

Cannabis, THC and Anesthesia

A review of the anesthetic implications of marijuana use

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