Clinical Professor Dept Anesthesiology SUNY @ Buffalo
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Introduction: With the recent legalization of Cannabis, and observed increased use of cannabis by our OS sedation population we initiated an evaluation of a Pre-Sedation Cannabis Use Score (PCUS). We noted also that some adolescents do acknowledge cannabis use on the routine pre-sedation evaluation, as such adolescent patients (16-17 yo) were added to our adult protocol with an IRB amendment. This included the development of a special consent process for the recruitment of adolescents concerning their recreational drug use. The aim of this study was to evaluate the reported cannabis use patterns and sedation outcomes for adolescent patients.
Methods: Adult recreational cannabis use in NY state is legal, however obtaining consent for information concerning a Minor’s cannabis use was challenging. A two-step process was used: Parents were asked for parental permission and whether they needed to see the PCUS. The adolescent was asked if they would participate (assent) and if their parents could see the PCUS after completion. This resulted in 6 possible consent process outcomes from which recruitment was possible in 3 cases. Pre-operatively the patients completed our 25-item questionnaire concerning factors such as; duration, quantity and type of cannabis use. Procedure details, sedation requirements and outcomes were recorded. Patients were recruited in a prospective convenience sample undergoing deep IV sedation for oral surgical procedures. The cannabis use stratification used the same PCUS as the adult component of the study.
Results: We have recruited a total of 64 adolescent patients so far. The average age, weight and BMI were 16.5 years, 64.0 kg and 21.7 respectively. Preop, 16% acknowledged cannabis use, this increased to 35% with the PCUS. 25% were Moderate or Heavy users (PCUS > 30). Heavy Users had a worse behavior score and higher sedation requirements. There have been no refusals to participate / consent so far by either the parent or the adolescent.
Conclusions: A significant number (35%) of adolescents acknowledge cannabis use. Recruitment of this adolescent group was successful, despite the more complex consent process. Cannabis use can affect both the quality and risks of sedation. Sedation outcomes appear to mirror that of adults with poorer behavior and increased sedation requirements.
