# Anesthesia Needs for Cannabis Users During Wisdom Tooth Surgery > **Author:** Benjamin Caplan, MD (ABFM Board Certified, MA Lic. #240562, NPI: 1962722637) > **Publisher:** CED Clinic (https://cedclinic.com) > **Canonical URL:** https://cedclinic.com/propofol-dosing-cannabis-users-third-molar-removal/ > **Published:** 2026-03-26T12:07:38-04:00 | **Last Modified / Clinically Audited:** 2026-09-28T10:37:40-04:00 > **Clinical Summary:** Explore propofol dosing cannabis users require during third molar removal under intravenous anesthesia for safe and effective sedation. --- CED Clinical Relevance  #56Monitored Relevance  Early-stage or contextual signal requiring further evidence before action. 🔬 Evidence Watch  |  CED Clinic AnesthesiaCannabisPerioperativePropofol[Clinical Study](https://cedclinic.com/cannabis-hyperemesis-syndrome-psychiatric-risk/) Journal Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons Study Type [Clinical Study](https://cedclinic.com/cannabis-hyperemesis-syndrome-psychiatric-risk/) Population Human participants Why This Matters This study addresses a critical gap in [perioperative care](https://cedclinic.com/anesthesia-cannabis-management-perioperative-care/) for the growing population of cannabis users. Understanding anesthetic requirements helps prevent inadequate sedation and intraoperative awareness while avoiding oversedation complications. Clinical Summary This prospective study of patients undergoing third molar extraction under IV general anesthesia found that cannabis users required significantly higher doses of propofol compared to non-users. The investigators developed a risk stratification system based on cannabis exposure years (CEYs), identifying patients with ≥2-3 years of multiple daily use as high-risk for increased anesthetic requirements. The study provides practical [clinical guidance](https://cedclinic.com/high-potency-thc-dosing-cannabis-flower-25-thc-safety/) for adjusting propofol dosing in cannabis-exposed patients, though it was limited to a single procedure type and anesthetic agent. Dr. Caplan’s Take “This confirms what many anesthesiologists have observed clinically – regular cannabis users often need more medication to achieve adequate sedation. The risk stratification approach gives us a practical framework for preoperative planning rather than guessing at dosing adjustments.” Clinical Perspective 🧠 Clinicians should routinely screen for [cannabis use](https://cedclinic.com/cannabis-cardiovascular-health-insights-2024/) patterns before procedures requiring anesthesia, paying particular attention to frequency and duration of use. Patients with significant cannabis exposure should be counseled about potentially increased anesthetic requirements and longer recovery times, and anesthesia teams should prepare for higher propofol dosing needs. 💬 Join the Conversation Have a question about how this applies to your situation? [Ask Dr. Caplan →](https://benjamincaplan.com/ask-dr-caplan) Want to discuss this topic with other patients and caregivers? [Join the forum discussion →](https://cedclinic.com/interact/discussion-forums/forum/cannabis-industry/) Have thoughts on this? Share it: [𝕏 Share on X](https://twitter.com/intent/tweet?text=Just%20read%20this%20on%20CEDclinic.com%3A%20Do%20Cannabis%20Users%20Require%20More%20Anesthesia%20During%20Third%20Molar%20Removal%20Under%20Intra...%20%40drcaplan&url=https%3A//pubmed.ncbi.nlm.nih.gov/41713495/)[in Share on LinkedIn](https://www.linkedin.com/sharing/share-offsite/?url=https%3A//pubmed.ncbi.nlm.nih.gov/41713495/)[🦥 Share on BlueSky](https://bsky.app/intent/compose?text=Just%20read%20this%3A%20Do%20Cannabis%20Users%20Require%20More%20Anesthesia%20During%20Third%20Molar%20Removal%20Under%20Intra...%20--%20via%20%40drcaplan.bsky.social%20https%3A//pubmed.ncbi.nlm.nih.gov/41713495/)[📷 Follow on Instagram](https://www.instagram.com/drbenjamincaplan/)[📝 Read more on Substack](https://substack.com/@doctorapproved)[🔔 Subscribe via RSS](https://cedclinic.com/category/cannabis-news/feed/) 📰 Source: [https://pubmed.ncbi.nlm.nih.gov/41713495/](https://pubmed.ncbi.nlm.nih.gov/41713495/) Table of Contents - [FAQ](#FAQ)[Do cannabis users require more anesthesia during oral surgery?](#Do_cannabis_users_require_more_anesthesia_during_oral_surgery) - [Which cannabis users are at highest risk for requiring more anesthesia?](#Which_cannabis_users_are_at_highest_risk_for_requiring_more_anesthesia) - [Should I tell my anesthesiologist about my cannabis use before surgery?](#Should_I_tell_my_anesthesiologist_about_my_cannabis_use_before_surgery) - [How should anesthesiologists prepare for cannabis users undergoing oral surgery?](#How_should_anesthesiologists_prepare_for_cannabis_users_undergoing_oral_surgery) - [Is this finding limited to oral surgery or does it apply to other procedures?](#Is_this_finding_limited_to_oral_surgery_or_does_it_apply_to_other_procedures) - [Related](#Related) ## FAQ #### Do cannabis users require more anesthesia during oral surgery? Yes, this study found that cannabis users required significantly more propofol (total milligrams of propofol, TMP) during third molar removal under intravenous general anesthesia compared to non-users. The increased anesthetic requirement appears to correlate with both duration and frequency of [cannabis use](https://cedclinic.com/cannabis-cardiovascular-health-insights-2024/). #### Which cannabis users are at highest risk for requiring more anesthesia? Cannabis users with ≥2-3 years of use and multiple daily sessions are considered high risk for increased propofol requirements. The study used cannabis exposure years (CEYs) to stratify patients into high-risk, moderate-risk, and low-risk categories based on duration and frequency of use. #### Should I tell my anesthesiologist about my cannabis use before surgery? Yes, it’s essential to disclose cannabis use to your anesthesiologist before any procedure requiring general anesthesia. This information allows the anesthesia team to properly plan and adjust medication dosages to ensure safe and effective anesthesia during your procedure. #### How should anesthesiologists prepare for cannabis users undergoing oral surgery? Anesthesiologists should obtain detailed cannabis use history including duration and frequency of use to assess risk level. They should be prepared to administer higher doses of propofol and closely monitor patients, as cannabis users may require significantly more anesthetic agents to achieve adequate sedation. #### Is this finding limited to oral surgery or does it apply to other procedures? This specific study focused on third molar removal under intravenous general anesthesia, so the findings are most directly applicable to oral surgery procedures. However, the underlying mechanism suggests cannabis users may require higher anesthetic doses across various surgical procedures, though more research is needed to confirm this broader application. {“@context”: “https://schema.org”, “@type”: “ScholarlyArticle”, “headline”: “Do Cannabis Users Require More Anesthesia During Third Molar Removal Under Intravenous General Anesthesia When Compared to Nonusers?”, “url”: “https://pubmed.ncbi.nlm.nih.gov/41713495/”, “about”: “journal oral maxillofacial surgery official journal”, “isPartOf”: “Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons”} [https://cedclinic.com/contact/](https://cedclinic.com/contact/) Physician-Led, Whole-Person Care A doctor who takes the time to truly understand you. Personal care that starts with listening and is guided by experience and ingenuity. Health, Longevity, Wellness One-on-One Cannabis Guidance Metabolic Balance [Leave a Message](https://cedclinic.com/contact/) [Metabolic Care](https://cedclinic.com/metabolic/metabolic-how-it-works/) [Medical Consulting](https://cedclinic.com/book/) [Cannabis Care](https://cedclinic.com/book/) [https://cedclinic.com/contact/](https://cedclinic.com/contact/) RELATED READING AT CED CLINIC Continue exploring the evidence [Do Cannabis Users Require More Anesthesia During Third Molar Removal Under Intravenous General Anesthesia When Compared to Nonusers?](https://cedclinic.com/cannabis-anesthesia-requirements-oral-surgery-propofol-dosing/) Detailed clinical study on anesthesia requirements and propofol dosing differences between cannabis users and nonusers during oral surgery. [Read the Study](https://cedclinic.com/cannabis-anesthesia-requirements-oral-surgery-propofol-dosing/) [Regular Cannabis Users May Need More Anesthesia for Wisdom Teeth Removal](https://cedclinic.com/regular-cannabis-users-may-need-more-anesthesia-for-wisdom-teeth-removal/) Explore evidence showing increased anesthesia needs in regular cannabis users undergoing wisdom teeth extraction procedures. [Learn More](https://cedclinic.com/regular-cannabis-users-may-need-more-anesthesia-for-wisdom-teeth-removal/) [Cannabis Use Disorder Treatment Europe Review](https://cedclinic.com/cannabis-use-disorder-treatment-europe-evidence-watch/) Review of [cannabis use disorder](https://cedclinic.com/sex-differences-cannabis-stress-reactivity-oxytocin/) treatments in Europe, providing context for cannabis exposure and clinical implications. [Explore Review](https://cedclinic.com/cannabis-use-disorder-treatment-europe-evidence-watch/) ### Related --- ### Verification & Medical Governance - **Lead Clinical Author:** Benjamin Caplan, MD - **Credentials:** Board Certified in Family Medicine (ABFM), Founder & CMO CED Clinic & CED Foundation, Author of *The Doctor-Approved Cannabis Handbook* (Penguin Random House). - **Clinical Scale:** 350,000+ lifetime evaluations overseen; 81,008-patient Real-World Evidence Registry (`~/.ced_rwe_vault.db`); 125,000+ peer-reviewed study literature observatory (`http://localhost:8768/api/explorer/terminal`). - **License Verification:** Commonwealth of Massachusetts License #240562 (https://checkahealthlicense.mass.gov/). - **NPI Registry:** 1962722637 (https://npiregistry.cms.hhs.gov/provider-view/1962722637). - **Ethics & Data Privacy:** Clinical registry observations adhere strictly to HIPAA Safe Harbor de-identification (45 CFR § 164.514(b)) and criteria for secondary research exemption under 45 CFR § 46.104(d)(4).