Cannabis and Surgery: Guidelines for Patients

What Researchers Found About and Cannabis

Updated January 24, 2026Regional Anesthesia and Pain Medicine, 2023

The Study at a Glance

Positive with Caveats

Published

Regional Anesthesia and Pain Medicine, 2023

Researchers

American Society of Regional Anesthesia and Pain Medicine (United States)

Study Type

Systematic Review

Key Finding

These consensus guidelines from the American Society of Regional Anesthesia address managing surgical patients who use cannabis. Key points: cannabis users may need higher anesthetic doses, be at increased risk for negative outcomes, and should disclose use to surgical teams.

Key Finding: These consensus guidelines from the American Society of Regional Anesthesia address managing surgical patients who use cannabis. Key points: cannabis users may need higher anesthetic doses, be at increased risk for negative outcomes, and should disclose use to surgical teams.

What Researchers Studied About This Condition and Cannabis

More people are using cannabis for medical and recreational purposes, but what does this mean for surgery? Do surgeons and anesthesiologists need to know?

The American Society of Regional Anesthesia and Pain Medicine convened an expert panel to develop the first consensus guidelines on managing surgical patients who use cannabis.

These guidelines address critical questions: Should surgery be postponed? How should anesthesia be adjusted? What should patients disclose?

How This Systematic Review Was Conducted

Expert panel developed guidelines using modified Delphi method:

• Expert working group convened in November 2020 • Addressed 9 key clinical questions • Multiple rounds of voting to achieve consensus • Required 75% agreement for recommendations • Achieved 100% consensus on all 9 questions • Focused on safe management of surgical patients

This Condition Treatment Results

The Main Results:

  • 1Cannabis users may be at increased risk for negative surgical outcomes
  • 2Patients should disclose cannabis use to surgical teams
  • 3Anesthetic and analgesic doses may need adjustment
  • 4Specific guidance for pregnant patients using cannabis
  • 5Considerations for postponing elective surgery
  • 6Postoperative monitoring recommendations

By the Numbers

StatisticWhat It Means
9key clinical questions addressed
100%consensus achieved among experts
Increasedrisk for negative outcomes in cannabis users
Adjustanesthetic doses may be needed
9

key clinical questions addressed

100%

consensus achieved among experts

Increased

risk for negative outcomes in cannabis users

Adjust

anesthetic doses may be needed

What This Means for This Condition Patients

If you use cannabis and need surgery, here's what you need to know:

Always disclose cannabis use: • Tell your surgeon, anesthesiologist, and preoperative team • Include both medical and recreational use • Don't hide it—your safety depends on this information

Why disclosure matters: • Cannabis can interact with anesthesia • You may need higher doses of certain medications • Monitoring may need to be adjusted • Risk management requires knowing your use

Surgical risks to know about: • Cannabis users may be at increased risk for complications • Effects on blood pressure and heart rate during surgery • Potential for increased pain or anesthetic requirements

Questions to ask your surgical team: • Should I stop cannabis before surgery? How long before? • Will my anesthesia plan be adjusted? • What should I do about pain after surgery? • When can I resume cannabis use?

Key takeaway: Don't be afraid to discuss cannabis use—your surgical team needs this information to keep you safe.

Quick Answers: This Condition and Cannabis

Direct answers based on the findings of this study:

Research Summary: Answers are based on published peer-reviewed studies and represent research findings, not medical recommendations. Individual results may vary. Always consult a healthcare provider before making treatment decisions.

Should I tell my surgeon I smoke weed?

Yes, always. Official anesthesia guidelines say marijuana affects your surgery—anesthesia doses may need adjusting, and hiding your use increases risks. Be honest; they're not judging you, they're keeping you safe.

Source: Kohan et al., Regional Anesthesia and Pain Medicine, 2023 (PMID: 36596580)

Can I smoke weed before surgery?

Tell your surgeon first—cannabis users may be at increased risk for negative surgical outcomes according to 2023 anesthesia guidelines. Your team can manage these risks if they know, but not if you hide it.

Source: Kohan et al., Regional Anesthesia and Pain Medicine, 2023 (PMID: 36596580)

Does marijuana affect anesthesia?

Yes. Anesthesia guidelines note cannabis users may need dose adjustments for anesthetics and pain medications. Your surgical team may also modify monitoring and postoperative care based on your marijuana use.

Source: Kohan et al., Regional Anesthesia and Pain Medicine, 2023 (PMID: 36596580)

This is educational content, not medical advice

The research summarized here is for informational purposes only. Individual results may vary, and what works in studies may not work the same way for everyone. Always consult with a qualified healthcare provider before making changes to your treatment plan or starting medical cannabis therapy.

Important Limitations

This study has some caveats to keep in mind when interpreting the results:

  • Based on limited available evidence
  • Some recommendations extrapolated from related data
  • Rapidly evolving field may require updates
  • Individual patient factors may require deviations
  • Specific dosing recommendations limited

The Bottom Line on Cannabis for This Condition

These groundbreaking guidelines from the American Society of Regional Anesthesia provide the first consensus recommendations for managing surgical patients who use cannabis. The key message: cannabis users may be at increased risk during surgery and should always disclose their use to the surgical team. Anesthesia and pain management may need adjustment. If you use cannabis and have surgery planned, discuss your use openly with your healthcare team—your safety depends on it.

Do You Qualify for Medical Marijuana?

If you're living with qualifying condition, you may qualify for a medical marijuana card. Our licensed physicians can evaluate you from home via telehealth.

Related Research & Resources

Source

Shah S, Schwenk ES, Sondekoppam RV, et al. "ASRA Pain Medicine consensus guidelines on the management of the perioperative patient on cannabis and cannabinoids" Regional Anesthesia and Pain Medicine. 2023. DOI: 10.1136/rapm-2022-104013

Study information sourced from PubMed®, U.S. National Library of Medicine.

Medically Reviewed By

MMJ.com Medical Advisory Board

Last Updated: January 24, 2026

Important Information

Not Medical Advice: This research summary is for educational purposes only. It should not be used to diagnose, treat, cure, or prevent any disease or medical condition. Always consult a qualified healthcare provider before starting or changing any treatment.

Individual Variation: Research findings represent group averages. Your individual response to cannabis may differ based on genetics, other medications, underlying conditions, and many other factors.

Last reviewed: January 24, 2026

Important Notices

Research Summary Disclaimer

This content represents our interpretation of published scientific research for educational purposes. It should not be used to make treatment decisions without consulting a qualified healthcare provider. Individual results may vary from study findings.

FDA Notice

These statements have not been evaluated by the FDA. Cannabis is not intended to diagnose, treat, cure, or prevent any disease. The FDA has not approved cannabis for any medical condition except specific prescription medications.

Copyright & Fair Use

Research summaries are provided under fair use (17 U.S.C. § 107) for educational purposes. We provide brief summaries with attribution, not full reproductions. All studies remain the intellectual property of their respective authors and publishers.

Data Sources

Study information sourced from PubMed®, U.S. National Library of Medicine. Inclusion does not imply endorsement by NLM, NIH, or the federal government.

For complete information, see our Terms of Use and Research Content Policy.

FAQs: Cannabis for This Condition

Should I tell my surgeon I use cannabis?

Yes, absolutely. These ASRA guidelines emphasize that cannabis users should disclose their use to surgical teams. This information affects anesthesia planning and helps manage surgical risks.

Does cannabis affect anesthesia?

Yes. The guidelines note that anesthetic and analgesic doses may need adjustment for cannabis users. Regular users may require higher doses of certain medications.

Is surgery riskier if you use cannabis?

Yes, disclosure is critical. The guidelines state that surgical patients using cannabinoids are at "potential increased risk for negative perioperative outcomes." Disclosing use allows the surgical team to manage these risks.