Table 5.

Potential perioperative cardiovascular outcomes in cannabis users.

Intraoperative Period
1. New or naïve users (within 2 h of consumption)  • Sympathetic hyperactivity + parasympathetic inhibition produced by THC potentiates cardiovascular response to surgical trauma and pain → ↑HR, ↑contractility, ↑MVO2 → Myocardial ischemia & malignant arrhythmias (68, 134, 135). 2. Increase anesthetic demands  • Severe hypotension (vasodilation + myocardial depression) (130–132)  • Sympathetic overactivity may offset hypotension induced by higher doses of GABAergic anesthetics. 3. Chronic and heavy users  • Bradycardia and postural/orthostatic hypotension (30, 134).  • Refractory hypotension when cannabis is combined with amphetamines (138).
Postoperative Period
• Myocardial Infarction (136, 163, 164, 167) • Arrhythmias (137) • Cerebrovascular ischemic events (163, 164, 167), • Deep venous thrombosis (165)