GP1b - Is Recreational Marijuana Use Associated With Changes in the Anesthetic Requirements or Vital Signs During Intravenous Sedation? A Prospective Cohort Study

Abstract: Recreational marijuana use in the United States has continued to increase since its legalization by many states. The potential for drug interactions between marijuana and anesthetic medications is a significant concern. No prospective studies have been performed, leaving a large void in the availability of quality data.^1,2 The purpose of the present study is to assess the effects of marijuana on the anesthetic requirements and the vital signs on patients undergoing deep intravenous (IV) sedation during ambulatory procedures.

A prospective cohort study was conducted in the Department of Oral and Maxillofacial Surgery at Temple University Kornberg School of Dentistry from March 2025 to March 2026. Institutional Review Board (IRB) approval was obtained prior to study initiation. Patients were eligible for inclusion if they were 13 years of age or older and classified as either marijuana users or non-users, American Society of Anesthesiologists (ASA) physical status classification of I or II, and scheduled to undergo surgical extraction of at least 2 mandibular third molars. Patients were excluded if they reported use of other substances, including amphetamines, cocaine, benzodiazepines, or opioids, had incomplete clinical records, or reported marijuana use on the morning of the procedure.

The primary outcome variable included difference in anesthetic medication (propofol) requirements in 2 groups (marijuana users and non-marijuana users). The secondary outcome variable included changes in the vital signs recorded at 5 time-points: baseline (TB), 5 minutes after initial sedative drug administration (T5), 10 minutes after drug administration (T10), 20 minutes after drug administration (T20), and 30 minutes after drug administration (T30). Covariates included age, gender, race, weight, height, body mass index (BMI), duration of surgery, smoking history, alcohol use, data on psychiatric diagnosis and psychiatric medications, Bispectral index (BIS), type, form, frequency, and duration of marijuana use.

Descriptive statistics were calculated. Independent samples t-tests were used to analyze association between exposure and outcome variables. Statistical significance was set at P < .05, with a 95% confidence interval.

Data analyses were performed using GraphPad Prism 10. Descriptive statistics were calculated for all variables. A total of 71 patients were included, with 36 marijuana users and 35 non-users. The mean propofol requirement for marijuana users was 423.69 (SD = 261.05), compared to 234.38 (SD = 141.43) in non-users (P value .002) (Fig 1). The mean value of mean arterial pressure (MAP) for marijuana users was 78.89 (SD = 12.06), compared to 75.78 (SD = 22.15) in non-users (P > .05) (Fig 2). The mean heart rate (HR) for marijuana users was 91.94 (SD = 12.34), compared to 89 (SD = 11.85) in non-users (P > .05) (Fig 3).

Recreational marijuana use was associated with significantly increased propofol requirements in patients undergoing intravenous sedation for ambulatory oral and maxillofacial surgery procedures. No significant differences were observed in intraoperative mean arterial pressure or heart rate between marijuana users and non-users.

This study was supported by a research grant from the Oral and Maxillofacial Surgery Foundation.


1. Gangwani P, Lillian D, Dobbins J, Feng C, Vorrasi J, Kolokythas A. Is Recreational Marijuana Use Associated With Changes in the Vital Signs or Anesthetic Requirements During Intravenous Sedation? J Oral Maxillofac Surg. 2023 May;81(5):527-535

2. Ripperger D, Atte A, Ritto F. Cannabis Users Require More Anesthetic Agents for General Anesthesia in Ambulatory Oral and Maxillofacial Surgery Procedures. J Oral Maxillofac Surg. 2023 Dec;81(12):1460-1465