Cannabis Use and Inhalational Anesthesia Administration in Older Adults: A Propensity-matched Retrospective Cohort Study-Reference-Cited by-同舟云学术

Cannabis Use and Inhalational Anesthesia Administration in Older Adults: A Propensity-matched Retrospective Cohort Study

Published:2024-08-27 Issue: Volume: Page:
ISSN:0003-3022
Container-title:Anesthesiology
language:en
Short-container-title:

Author:

Sajdeya Ruba¹^ORCID,Rouhizadeh Masoud²,Cook Robert L.³,Ison Ronald L.⁴,Bai Chen⁵,Jugl Sebastian⁶,Gao Hanzhi⁷,Mardini Mamoun T.⁸,Zandbiglari Kimia⁹,Adiba Farzana I.¹⁰,Dasa Osama¹¹,Winterstein Almut G.¹²,Price Catherine C.¹³,Pearson Thomas A.¹⁴,Seubert Christoph N.¹⁵,Tighe Patrick J.¹⁶

Affiliation:

1. 1Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida.

2. 2Center for Drug Evaluation and Safety, Department of Pharmaceutical Outcomes and Policy, University of Florida, Gainesville, Florida.

3. 3Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida.

4. 5Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, Florida.

5. 4Department of Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida.

6. 6Center for Drug Evaluation and Safety, Department of Pharmaceutical Outcomes and Policy, University of Florida, Gainesville, Florida.

7. 7Department of Biostatistics, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida.

8. 8Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, Florida.

9. 9Center for Drug Evaluation and Safety, Department of Pharmaceutical Outcomes and Policy, University of Florida, Gainesville, Florida.

10. 10Center for Drug Evaluation and Safety, Department of Pharmaceutical Outcomes and Policy, University of Florida, Gainesville, Florida.

11. 11Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida.

12. 12Center for Drug Evaluation and Safety, Department of Pharmaceutical Outcomes and Policy, University of Florida, Gainesville, Florida.

13. 13Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida.

14. 14Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida.

15. 15Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, Florida.

16. 16Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, Florida.

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. Average intraoperative isoflurane or sevoflurane minimum alveolar concentration equivalents between older adults with and without cannabis use were compared. Methods The electronic health records of 22,476 surgical patients 65 yr or older at the University of Florida Health System between 2018 and 2020 were reviewed. The primary exposure was cannabis use within 60 days of surgery, determined via (1) a previously published natural language processing algorithm applied to unstructured notes and (2) structured data, including International Classification of Diseases 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 or sevoflurane minimum alveolar concentration equivalents at 1-min resolution. No a priori minimally clinically important difference was established. Patients demonstrating cannabis use were matched 4:1 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 age was 69 (67 to 73) yr; 872 (65.0%) were male, and 1,143 (85.3%) were non-Hispanic White. The median (interquartile range) anesthesia duration was 175 (118 to 268) min. 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 vs. 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. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

Publisher

Ovid Technologies (Wolters Kluwer Health)

Link

https://pubs.asahq.org/anesthesiology/article-pdf/doi/10.1097/ALN.0000000000005146/713103/aln.0000000000005146.pdf

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