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Cannabis Use and Inhalational Anesthesia Administration in Older Adults: A Propensity Matched Retrospective Cohort Study.
Sajdeya, Ruba; Rouhizadeh, Masoud; Cook, Robert L; Ison, Ronald L; Bai, Chen; Jugl, Sebastian; Gao, Hanzhi; Mardini, Mamoun T; Zandbiglari, Kimia; Adiba, Farzana I; Dasa, Osama; Winterstein, Almut G; Price, Catherine C; Pearson, Thomas A; Seubert, Christoph N; Tighe, Patrick J.
Afiliación
  • Sajdeya R; Department of Epidemiology, College of Public Health & Health Professions & College of Medicine, University of Florida, Gainesville, FL, USA.
  • Rouhizadeh M; Center for Drug Evaluation and Safety (CoDES), Department of Pharmaceutical Outcomes & Policy, University of Florida, Gainesville, FL, USA.
  • Cook RL; Department of Epidemiology, College of Public Health & Health Professions & College of Medicine, University of Florida, Gainesville, FL, USA.
  • Ison RL; Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA.
  • Bai C; Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL, USA.
  • Jugl S; Center for Drug Evaluation and Safety (CoDES), Department of Pharmaceutical Outcomes & Policy, University of Florida, Gainesville, FL, USA.
  • Gao H; Department of Biostatistics, College of Public Health & Health Professions & College of Medicine, University of Florida, Gainesville, FL, USA.
  • Mardini MT; Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, USA.
  • Zandbiglari K; Center for Drug Evaluation and Safety (CoDES), Department of Pharmaceutical Outcomes & Policy, University of Florida, Gainesville, FL, USA.
  • Adiba FI; Center for Drug Evaluation and Safety (CoDES), Department of Pharmaceutical Outcomes & Policy, University of Florida, Gainesville, FL, USA.
  • Dasa O; Department of Epidemiology, College of Public Health & Health Professions & College of Medicine, University of Florida, Gainesville, FL, USA.
  • Winterstein AG; Center for Drug Evaluation and Safety (CoDES), Department of Pharmaceutical Outcomes & Policy, University of Florida, Gainesville, FL, USA.
  • Price CC; Department of Clinical and Health Psychology, College of Public Health & Health Professions, University of Florida, Gainesville, FL, USA.
  • Pearson TA; Department of Epidemiology, College of Public Health & Health Professions & College of Medicine, University of Florida, Gainesville, FL, USA.
  • Seubert CN; Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL, USA.
  • Tighe PJ; Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL, USA.
Anesthesiology ; 2024 Jul 09.
Article en En | MEDLINE | ID: mdl-38980341
ABSTRACT

BACKGROUND:

Cannabis use is associated with higher intravenous anesthetic administration. Similar data regarding inhalational anesthetics are limited. With rising cannabis use prevalence, understanding any potential relationship with inhalational anesthetic dosing is crucial. We compared average intraoperative isoflurane/sevoflurane minimum alveolar concentration equivalents between older adults with and without cannabis use.

METHODS:

The electronic health records of 22,476 surgical patients ≥65 years old at the University of Florida Health System between 2018-2020 were reviewed. The primary exposure was cannabis use within 60 days of surgery, determined via i) a previously published natural language processing algorithm applied to unstructured notes and ii) structured data, including International Classification of Disease codes for cannabis use disorders and poisoning by cannabis, laboratory cannabinoids screening results, and RxNorm codes. The primary outcome was the intraoperative time-weighted average of isoflurane/sevoflurane minimum alveolar concentration equivalents at one-minute resolution. No a priori minimally clinically important difference was established. Patients demonstrating cannabis use were matched 41 to non-cannabis use controls using a propensity score.

RESULTS:

Among 5,118 meeting inclusion criteria, 1,340 patients (268 cannabis users and 1,072 nonusers) remained after propensity score matching. The median and interquartile range (IQR) age was 69 (67, 73) years; 872 (65.0%) were male, and 1,143 (85.3%) were non-Hispanic White. The median (IQR) anesthesia duration was 175 (118, 268) minutes. After matching, all baseline characteristics were well-balanced by exposure. Cannabis users had statistically significantly higher average minimum alveolar concentrations than nonusers [mean±SD 0.58±0.23 versus 0.54±0.22, respectively; mean difference=0.04; 95% confidence limits, 0.01 to 0.06; p=0.020].

CONCLUSION:

Cannabis use was associated with administering statistically significantly higher inhalational anesthetic minimum alveolar concentration equivalents in older adults, but the clinical significance of this difference is unclear. These data do not support the hypothesis that cannabis users require clinically meaningfully higher inhalational anesthetics doses.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Anesthesiology Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Anesthesiology Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos