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Cannabis users who smoke or vape may require significantly higher doses of propofol during upper endoscopy procedures, a new study finds. Researchers found inhalation users needed notably more propofol than nonusers during EGD — but the effect didn't hold for colonoscopy. The takeaway: tell your anesthesiologist exactly how you use cannabis, not just whether you do.
Cannabis users who smoke or vape may need meaningfully higher doses of propofol when undergoing upper endoscopy (EGD), according to a study presented at the American Society of Anesthesiologists' annual meeting. The finding adds nuance to how anesthesiologists should assess cannabis use before procedures — because how patients consume it matters just as much as whether they do.
Researchers reviewed 280 endoscopic procedures and found that inhalation cannabis users required an average of 192.8 mg of propofol during EGD, compared to 151.4 mg for nonusers. Oral (edible) users showed no significant difference. Notably, the effect was specific to EGD — no meaningful differences were observed in colonoscopy patients.
By the Numbers:
Why it matters: Simply asking "Do you use cannabis?" is no longer enough. Anesthesiologists need to know the route, frequency, and timing of use to safely and effectively dose sedation — making detailed cannabis screening a new clinical standard for pre-procedure assessments.
