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Anesthesiology/THC in blood during Anesthesiology

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Question
JM,
I am 28 male, 5'3 133lb, I am having surgery a week from monday to remove a tumor on my spine. Currently I am smoking medical grade marijuana to deal with the pain. Will the THC already in my blood have any effect with the anesthesia? i.e being to powerful. Should I stop smoking today - a week beforehand?

- Josh
p.s although he did prescribe it for me - since in the state I am located in you can only be prescribe for chemo treatment - my neurosurgeon is aware that I smoke, when I asked him if it was ok if I did , to help the pain, and he said, "yes". But because that was months ago, and I know he has hundreds of patients, I doubt if he remembers.

Answer
A PubMed search with the pertinent keywords finds no good research specifically addressing your question.  So my answer is based on my own experience and what IS known:  Oral THC in the form of "Marinol" has been used for many years perioperatively in cancer patients undergoing anesthesia for a variety of reasons without detrimental effects.  I'll bet it has been tried as a way to reduce post operative nausea and vomiting--but I can't find a study that objectively assessed this.  But you're smoking marijuana, not swallowing a purified pill---so I think it's safe to say that smoke, which irritates one's larynx and results in coughing, secretions, larygnospasm and airway inflammation around the time of an anesthetic, WILL cause some degree of problem during your anesthesia.  Some years ago (1980's) it was shown that stopping cigarette smoking within two weeks of anesthesia resulted in a reactive 'hyper' response to the sudden lack of cigarette smoke---patients were even MORE likely to have problems right after ceasing their smoking habit than if they'd kept on smoking. The recommendation since then has been not to stop smoking within two weeks of surgery.  And that's my bottom line.  Make sure the anesthesiologist has your smoking history prior to surgery.  

Anesthesiology

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JM Starkman, MD

Experience

Over twenty-five years of adult and pediatric, inpatient and outpatient clinical anesthesia practice--some private, some group.

Organizations
American Association of Physicians and Surgeons. My county medical society.

Publications
[not a researcher]

Education/Credentials
American medical school graduate. Board Certified. Fellowship trained Cardiovascular and Pediatric anesthesia subspecialist.

Past/Present Clients
Over 20,000 anesthetics, the majority of which have been personally managed, with less than 5% consisting of supervising nurse anesthetists or in-training resident physicians.

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