Original researchASRA Pain Medicine consensus guidelines on themanagement of the perioperative patient oncannabis and cannabinoidsShalini Shah ,EricS Schwenk 2 Rakesh V Sondekoppam,3Hance ClarkeMark Zakowski,Rachel S Rzasa-Lynn,Brent Yeung,?Kate Nicholson,Gary Schwartz,1W Michael Hooten Mark Wallace,12Anesth Pain Med:first publishedEugene R Viscusi Samer Narouze13Additional supplementalABSTRACTmaterial is published onlineBackground The past two decades have seen anWHAT IS ALREADY KNOWN ON THIS TOPIConly.To view,please visit theThere is a wide variability in consumptionjoural online (http://dx.doiorq/increase in cannabis use due to both regulatory changes10.1136rapm-2022-104013.and an interest in potential therapeutic effects of thepatterns among the US populationFor numbered affiliations seesubstance,yet many aspects of the substance and their(recreational,medicinal,frequent,infrequent)as well as in formulations (cannabidiol,end of article.health implications remain controversial or unclear.Methods In November 2020,the American Societytetrahydrocannabinol,or combination)10.1138apm-2022-104013Correspondence toof Regional Anesthesia and Pain Medicine charged theAlthough cannabis is reputed to have medicinalDr Shalini Shah,DepartmentCannabis Working Group to develop quidelines for theand psychoactive effects,its implications inof Anesthesiology,UC Irvineperioperative use of cannabis.The Perioperative Usethe perioperative care setting are still largelyHealthcare,Orange CA92868,of Cannabis and Cannabinoids Guidelines Committeeunknown.USA;ssshah1@hs.uci.eduwas charged with drafting responses to the nineReceived 27 August 2022key questions using a modified Delphi method withWHAT THIS STUDY ADDSJanuaryAccepted 8 November 2022the overall goal of producing a document focusedThe guidelines offer critical education abouton the safe management of surgical patients usingterminology,pharmacology,and clinicalcannabinoids.A consensus recommendation requiredimplications associated with cannabinoid2023≥75%agreement.therapy in the perioperative period.Results Nine questions were selected,with100%consensus achieved on third-round voting.HOW THIS STUDY MIGHT AFFECT RESEARCH,Topics addressed included perioperative screening.PRACTICE OR POLICYDownloadedpostponement of elective surgery,concomitant use ofIdentifying current evidence-based aspectsopioid and cannabis perioperatively,implications forand knowledge gaps of cannabinoid therapyparturients,adjustment in anesthetic and analgesicsshould facilitate both clinicians and researchersfromintraoperatively,postoperative monitoring,cannabis usein improving the care of patients in thedisorder,and postoperative concerns.Surgical patientsperioperative period.using cannabinoids are at potential increased risk fornegative perioperative outcomes.Conclusions Specific clinical recommendations forhttp://rapm.bmjperioperative management of cannabis and cannabinoidsguideline is intended to enable person-centeredwere successfully creat
