Smoking or vaping cannabis, but not edibles, linked to need for more anesthesia during upper endoscopy, study suggests | Newswise

A study presented at the ANESTHESIOLOGY 2026 annual meeting suggests that patients who smoke or vape cannabis may require higher doses of the anesthetic propofol during upper endoscopy (EGD) compared to non-users or those who use edibles. The study reviewed 280 gastrointestinal endoscopic procedures, including 264 patients with complete cannabis use data: 217 non-users, 38 inhaled users, and 9 oral users. While overall cannabis users showed no significant difference in propofol dose, separating by route revealed a sharper pattern: average initial propofol dose was 138.7 mg for non-users, 168.5 mg for inhaled users, and 114.2 mg for oral users. The difference was most pronounced during EGD, where inhaled cannabis users required 192.8 mg of propofol versus 151.4 mg for non-users and 145.0 mg for oral users. No meaningful differences were observed for colonoscopy. The findings may explain conflicting results in earlier research that grouped all cannabis users together. Inhaled and edible cannabis are processed differently: smoking or vaping delivers THC rapidly through the lungs, while edibles are metabolized by the liver, producing different metabolites. Regular inhalation may also irritate the upper airway, potentially requiring deeper anesthesia. The authors emphasize that patients should be honest with their anesthesiologist about cannabis use, including method, frequency, and timing, and that these results do not suggest avoiding medically necessary endoscopy. Instead, they highlight the need for accurate information to tailor sedation. The study was led by Basavana Goudra, M.D., and included Katherine Green from Johns Hopkins University and Ankitha Jagadeesh from Rutgers University.

(Source：Newswise)