December 29, 2022

Is It Okay to Take CBD Oil Before Surgery?

CBD oil is dropped for a patient suffering from chronic pain

What does CBD oil do to your body under anesthesia? Is CBD oil safe before surgery and anesthesia? Here's what you need to know about CBD oil before surgery.

What is CBD oil?

Cannabis contains many plant compounds, but tetrahydrocannabinol (THC) and cannabidiol (CBD) are used most frequently in recreational and medical settings. Cannabis may have many medicinal properties (discussed in my previous blog posts and video). However, there are clear harms with human-modifications to otherwise natural cannabis.

CBD is lipid soluble and crosses the blood-brain barrier, so it easily suspends in oils from over-the-counter formulations

Does CBD Oil Have Benefits?

Many CBD oil claims are dubious and potentially harmful. Despite very little evidence, medical cannabis is typically used for:

  • Alzheimer disease
  • Amyotrophic lateral sclerosis (ALS)
  • Cachexia/wasting syndrome and AIDS
  • Cancer
  • Crohn's disease
  • Epilepsy and seizures
  • Multiple sclerosis (MS) with muscle spasticity
  • Severe and chronic pain
  • Posttraumatic stress disorder (PTSD)

You can read my previous article on the data behind marijuana use.

Most medical cannabis is used without significant supporting evidence, but some patients still feel they derive benefit, and I respect that as their doctor

What Happens with Cannabis Under Anesthesia?

CBD affects the brain and body in many ways under anesthesia. However, very few studies differentiate CBD oil from mixed cannabis (CBD + THC). Some important side effects of whole cannabis under anesthesia include:

  • Risk of vomiting under anesthesia: food can build up in the stomach from delayed gastric emptying
  • Heart attack risk: marijuana increases heart rate and cardiac stress
  • Worse pain after surgery
  • Nausea and vomiting after anesthesia (even though it may help nausea outside of surgery)
  • Emergence delirium, agitation, or combativeness when waking up from anesthesia
  • Longer wake up after anesthesia: also called delayed emergence
  • Risk of asthma attacks and laryngospasm

What About Pure CBD Oil Without THC?

To date, there is little evidence about serious harms from pure CBD oil, especially used topically, as directed by a doctor. Some side effects include:

  • Dry mouth
  • Diarrhea
  • Drowsiness
  • Medication interactions (especially blood thinners)

A major concern for any product is purity and potency. For example, many patients think they have a "pure CBD" product that actually has THC in it. This can have an entirely different risk profile.

CBD can be contaminated with THC and increase anesthesia and surgery risks

Always talk with your doctor, especially your anesthesiologist, about the safety of continuing CBD oil before surgery. The risks and benefits must be discussed before surgery because the risk of side effects can be serious with contaminated products.

The good news is that for many of my healthy patients, they can tolerate CBD oil without increased anesthetic risks during minor surgeries. As always, speak with your doctor about starting, stopping, or changing any medications, especially before surgery.

Visit Dr. Kaveh in San Francisco to experience how psychedelic medicine can help you overcome depression, anxiety, addiction, and chronic pain.

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