Patients who smoke or vape cannabis may require higher doses of propofol during upper endoscopy than nonusers or patients who consume cannabis edibles, according to research presented at the American Society of Anesthesiologists’ Anesthesiology 2026 annual meeting in San Diego.
Researchers reviewed 280 gastrointestinal endoscopic procedures at a single center, including 264 patients with complete cannabis use data. The analysis included 217 nonusers, 38 inhaled cannabis users and nine oral cannabis users, according to an Oct. 18 news release
During upper endoscopy, patients who inhaled cannabis required an average of 192.8 milligrams of propofol, compared with 151.4 milligrams for nonusers and 145 milligrams for oral cannabis users. Researchers found no meaningful differences in propofol requirements during colonoscopy.
Across all procedures, average initial propofol doses were 168.5 milligrams for inhaled users, 138.7 milligrams for nonusers and 114.2 milligrams for oral users. However, researchers found no significant difference when all cannabis users were grouped together.
Researchers suggested that differences in cannabis absorption and potential airway irritation from smoking or vaping may contribute to higher sedation requirements. They emphasized the importance of asking patients how they consume cannabis, how frequently they use it and when they last used it.
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