The Impact of Cannabis Use on Local Anesthetic Dosing During Hair Restoration Surgery: A Case Report, Proposed Mechanisms, and Clinical Recommendations

    March 2025 in “ Journal of Dermatological Treatment ”
    Aditya K. Gupta, Mesbah Talukder, Sharon A. Keene
    TLDR Cannabis users may need higher anesthetic doses during hair restoration surgery.
    This case report discusses the challenges of administering local anesthetics during hair restoration surgery in cannabis users, focusing on a 51-year-old male patient who required higher doses of anesthetics. The increased dosage is attributed to cannabis withdrawal and its vasodilatory effects, which may enhance anesthetic clearance, as well as the interaction of cannabinoids like CBD and THC with receptors and cytochrome P450 enzymes. The report stresses the importance of obtaining detailed cannabis use histories and adjusting anesthetic protocols to ensure patient safety and effective pain management. It also highlights the need for further research to understand the mechanisms behind altered anesthetic requirements in cannabis users and suggests personalized anesthetic management, including preoperative assessments and postoperative care to address potential interactions with pain medications and impacts on hair growth.
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