背景:在过去的二十年中,由于监管变化和对该物质的潜在治疗作用的兴趣,大麻的使用有所增加,然而,该物质的许多方面及其对健康的影响仍存在争议或不清楚。
方法:2020年11月,美国区域麻醉和疼痛医学学会责成大麻工作组制定围手术期使用大麻的指南。围手术期使用大麻和大麻素指南委员会负责使用改良的德尔菲方法起草对九个关键问题的答复,其总体目标是制作一份文件,重点是使用大麻素对手术患者进行安全管理。共识建议要求≥75%同意。
结果:选择了9个问题,就第三轮投票达成100%共识。主题包括围手术期筛查,推迟择期手术,围手术期同时使用阿片类药物和大麻,对产妇的影响,术中调整麻醉和镇痛药,术后监测,大麻使用障碍,和术后担忧。使用大麻素的手术患者围手术期不良结局的潜在风险增加。
结论:成功创建了大麻和大麻素的围手术期处理的具体临床建议。
The past two decades have seen an increase in cannabis use due to both regulatory changes and an interest in potential therapeutic effects of the substance, yet many aspects of the substance and their health implications remain controversial or unclear.
In November 2020, the American Society of Regional Anesthesia and Pain Medicine charged the Cannabis Working Group to develop
guidelines for the perioperative use of cannabis. The Perioperative Use of Cannabis and Cannabinoids
Guidelines Committee was charged with drafting responses to the nine key questions using a modified Delphi method with the overall goal of producing a document focused on the safe management of surgical patients using cannabinoids. A
consensus recommendation required ≥75% agreement.
Nine questions were selected, with 100%
consensus achieved on third-round voting. Topics addressed included perioperative screening, postponement of elective surgery, concomitant use of opioid and cannabis perioperatively, implications for parturients, adjustment in anesthetic and analgesics intraoperatively, postoperative monitoring, cannabis use disorder, and postoperative concerns. Surgical patients using cannabinoids are at potential increased risk for negative perioperative outcomes.
Specific clinical recommendations for perioperative management of cannabis and cannabinoids were successfully created.