Implications of cannabis use on sedation for endoscopic procedures

Woo, Matthew; Andrews, Christopher N.

doi:10.1016/j.gie.2019.06.005

Cited by 8 publications

(1 citation statement)

References 22 publications

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“…Also notable is a brief report from Canada suggesting that diphenhydramine can cause paradoxical agitation in chronic cannabis users. It is possible that in this small group of subjects, the diphenhydramine itself is causing patients to fail CS 19 . The strong residual association between adjunctive medication use and failure of conscious sedation after adjusting for these confounders (including illicit substance use) indicates that in their pre-procedure assessment the endoscopist is accurately incorporating additional risk factors for individuals likely to fail CS.…”

Section: Discussionmentioning

confidence: 93%

Predictors of Failed Conscious Sedation in Patients Undergoing an Outpatient Colonoscopy and Implications for the Adenoma Detection Rate

Cassell

Ross

Chang

et al. 2020

Sci Rep

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Guidelines to triage patients to conscious sedation (cS) or monitored anaesthesia care (MAc) for colonoscopy do not exist. We aimed to identify the cS failure rate, predictors of failure, and its impact on the adenoma detection rate (ADR). Strict (based on patient experience) and expanded (based on doses of sedative medications) definitions of CS failure were used. Patient and procedure-related variables were extracted. Multivariable logistic regression identified predictors for CS failure and the ADR. Among 766 patients, 29 (3.8%) and 175 (22.8%) patients failed CS by strict and expanded definitions, respectively. Female gender (OR 3.50; 95% CI: 1.37-8.94) and fellow involvement (OR 4.15; 95% CI: 1.79-9.58) were associated with failed CS by the strict definition. Younger age (OR 1.27, 95% CI: 1.07-1.49), outpatient opiate use (OR 1.71; 95% CI 1.03-2.84), use of an adjunct medication (OR 3.34; 95% CI: 1.94-5.73), and fellow involvement (OR 2.20; 95% CI: 1.31-3.71) were associated with failed CS by the expanded definition. Patients meeting strict failure criteria had a lower ADR (OR 0.30; 95% CI: 0.12-0.77). Several clinical factors may be useful for triaging to MAC. The ADR is lower in patients meeting strict criteria for failed cS.

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Section: Discussionmentioning

confidence: 93%