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Perioperative Management of the Pediatric Patient on Medicinal Marijuana: What Anesthesiologists Should Know

Flannery, Kaitlin M. MD, MPH; D’Souza, Genevieve MD; Agarwal, Rita MD, FAAP

doi: 10.1213/ANE.0000000000003956
Pediatric Anesthesiology
Continuing Medical Education

In 2018, 29 states allow the use of medicinal marijuana. In these states, minors, with parental permission, are granted access. Use has increased in some states, although there remains a paucity of clear evidence regarding usefulness and dosing. There are 2 Food and Drug Administration–approved synthetic derivatives. One purified compound was just approved by the Food and Drug Administration, and another is undergoing Food and Drug Administration review. This article will review the literature regarding the use of each of these compounds in the literature, with particular attention to data in children. The history, known pharmacology, data from nonmedicinal use, current evidence, and anesthetic considerations will be described.

From the Department of Anesthesiology, Perioperative and Pain Medicine, Stanford Health Care, Stanford, California.

Published ahead of print 23 October 2018.

Accepted for publication October 23, 2018.

Funding: None.

The authors declare no conflicts of interest.

Reprints will not be available from the authors.

Address correspondence to Kaitlin M. Flannery, MD, MPH, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford Medicine, Room H3580, 300 Pasteur Dr, Stanford, CA 94305. Address e-mail to

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