DDW: Cannabinoid Use Ups Sedation Requirements During Endoscopy

THURSDAY, May 26, 2022 (HealthDay News) — Baseline cannabinoid use is associated with higher sedation use during endoscopy with endoscopist-directed conscious sedation, according to a study presented at the 2022 Digestive Disease Week, held from May 21 to 24 in San Diego.

Yasmin Nasser, M.D., Ph.D., from University of Calgary in Alberta, Canada, and colleagues prospectively assessed the association between baseline cannabinoid use and sedation requirements for esophagogastroduodenoscopy (EGD) and colonoscopy among 419 adult outpatients.

The researchers found that baseline cannabinoid use was associated with high midazolam use (≥5 mg) during EGD (adjusted odds ratio [aOR], 2.89; 95 percent confidence interval [CI], 1.19 to 7.50) but not during colonoscopy (aOR 0.89; 95 percent CI, 0.41 to 1.91). There was an association between baseline cannabinoid use and administration of any diphenhydramine during EGD (aOR, 3.04; 95 percent CI, 1.29 to 7.30), with a nonsignificant trend seen for colonoscopy (aOR, 2.36; 95 percent CI, 0.81 to 7.04). There was also an association between baseline cannabinoid use and increased odds of requiring high total sedation (midazolam ≥5 mg, fentanyl ≥100 mcg, or any diphenhydramine during EGD; aOR, 3.72; 95 percent CI, 1.35 to 11.68). There was no independent association observed between cannabinoid use and fentanyl use or adverse events, nor was it associated with intraprocedural awareness or discomfort, according to the scores on the patient-reported scale for tolerability of endoscopic procedures.

“Given increasingly widespread cannabinoid use, endoscopists should be equipped with optimal sedation strategies for this population,” the authors write.