ONE TOKE OVER? Marijuana users may require higher doses of sedation before endoscopic procedures, a study suggests.

Be sure to ask patients scheduled for an endoscopy if they use marijuana, say researchers who found that regular cannabis use has a significant effect on the amount of sedation required to perform an endoscopic procedure.

Regular marijuana users needed 14% more fentanyl, 19.6% more midazolam and 220.5% more propofol than non-users, according to "Effects of Cannabis Use on Sedation Requirements for Endoscopic Procedures," published online last week in the Journal of the American Osteopathic Association.

"To our knowledge, this is a previously unreported effect of cannabis, and the exact mechanism of the interaction is unknown," say researchers.

The legalization of both medical and recreational marijuana may encourage patients to admit cannabis use and reveal it during medical questioning, the study's authors suggest.

Researchers reviewed 250 medical records from 1 endoscopy center and 1 endoscopist on cases performed between Jan. 1, 2016, and Dec. 31, 2017, after the legalization of recreational marijuana use in Colorado. Patients in the study were 18 years or older and had an endoscopic procedure done during the study period.

The researchers concluded that, "Determining cannabis use before procedural sedation can be an important tool for planning patient care and assessing both medication needs and possible risks related to increased dosage requirements during endoscopic procedures."

Mike Morsch