How Much More Medication Do Daily Marijuana Users Require for Sedation?

Classic Article Review  – Background: In the past, midazolam and fentanyl sedation was widely favored for gastrointestinal (GI) sedations. However, midazolam–fentanyl sedation became a challenge for so-called difficult-to-sedate (DTS) patients. Propofol infusion has become a popular method for colonoscopies and endoscopies in the United States. Propofol infusion is also a deep sedation method often used in outpatient oral and maxillofacial surgery (OMFS). With the legalization of marijuana, OMFS offices are encountering many more patients who are difficult to sedate. Objective: To compare the dose of fentanyl and propofol used in DTS patient groups versus controls undergoing endoscopy and colonoscopy. Design: Single center retrospective study. Methods: Charts of 1427 patients treated between January 2018 and April 2018 were reviewed. Patients were classified as DTS with heavy use of alcohol (n=105), daily users of marijuana (n=267), or opioids (n=178), had a diagnosis of posttra more...