Are you wondering whether you could use cannabidiol before surgery? CBD Clinicals gathers vital information to help you decide whether using CBD before surgery is the best course of action for you.  

How CBD May Help Before Surgery

CBD (cannabidiol) is an active constituent of hemp. Like marijuana (also called cannabis), hemp belongs to the Cannabis sativa species.

Although cannabidiol is a vital element of medical cannabis, the compound is extracted mostly from hemp plants. CBD may also be manufactured in a laboratory(1).

A 2021 animal study examined the influence of cannabidiol premedication on the course of isoflurane anesthesia and recovery in Wistar rats(2).

Isoflurane is a volatile anesthetic for the induction and maintenance of general anesthesia(3).

The study used Wistar rats that were pretreated with varying doses of CBD an hour before isoflurane anesthesia was given. The subjects were given CBD doses of 2, 10, 20, and 100mg kg-1 (per kg of body weight)(4).

The results showed that the impact of CBD on the course of isoflurane anesthesia depends on the dose.

Data suggest that CBD may reduce the induction time, the period between administering sedatives, and loss of consciousness(5).

Although the experiment was conducted on laboratory rats, the researchers recommended considering the data collected when CBD-treated patients undergo isoflurane anesthesia.

CBD interacts with the endocannabinoid system (ECS)(6). The ECS is present in almost all parts of the body and consists of vital components including cannabinoid receptors, primarily CB1 and CB2 receptors(7).

CBD may have a low binding affinity for CB1 and CB2 receptors. Still, it may antagonize them in the presence of THC. CBD may also reduce the efficacy and potency of THC and modulate pain perception(8).

The promise of pain reduction could benefit individuals about to undergo surgery.

Benefits of Using CBD Before Surgery: What Research Says

CBD has purported health benefits that may help relieve chronic pain, anxiety, and addiction(9). The non-psychoactive compound also has antioxidative and anti-inflammatory properties(10).

A survey from the International Journal of Spine Surgery demonstrated that CBD is a prevalent alternative therapy used by numerous patients with spine-related symptoms(11).

Out of the CBD users with a history of spine surgery, 29% of patients used the compound before their surgical procedure, 18% before and after their operation, and 53% used CBD after surgery(12).

Meanwhile, 63.0% of CBD users with spine-related pain said they would recommend cannabidiol to a friend for pain relief(13).

Based on the survey, about 66.7% of patients initially used CBD for potential relief of back pain. About 46.3% of CBD users benefited from pain relief, 33.3% reported improved sleep, and 20.4% experienced reduced anxiety(14).

A 2021 experimental pain study of cannabidiol in humans hypothesized that CBD’s pain-relieving properties are driven by pharmacological action and psychological placebo effects(15).

The placebo effect is when an individual’s mental and physical health appears to improve after taking a placebo or dummy treatment(16).

A systematic review and meta-analysis of placebo-controlled trials in surgery showed that such trials may provide high-quality data on the efficacy of surgical treatments(17).

Meanwhile, an animal study from the Phytomedicine journal examined the anticoagulant effects of a cannabis extract in an obese murine model(18).

Anticoagulants, or blood thinners, are medications that may prevent blood clots.

The results showed that Cannabis sativa and cannabinoids such as THC (tetrahydrocannabinol) and CBN (cannabinol) displayed anticoagulant activity, making it a promising therapy for diseases like type 2 diabetes(19).

THC is the primary mind-altering chemical in marijuana plants(20).

Meanwhile, CBN is also non-psychoactive like CBD(21). CBN is a cannabinoid isolated from the cannabis plant. CBN is a THC metabolite that may have potential anti-inflammatory and immunosuppressive activities(22).

A study from the Archives of Oral Biology hypothesized that the combination of CBD and CBN may provide an analgesic effect for chronic muscle pain disorders(23).

A recent study on the first 400 patients seeking CBD prescriptions in New Zealand suggested that patients with mental health conditions like anxiety and non-cancer chronic pain may benefit from CBD’s analgesic and anxiolytic (anti-anxiety) effects(24).

The studies expressed support for CBD’s purported therapeutic benefits. However, while the results are promising, they are still inconclusive.

Hence, more longitudinal research is necessary to determine CBD’s efficacy and long-term safety. Before using CBD oil before surgery, make sure to inform your clinician to solicit professional advice.

How Long Does CBD Take to Help Before Surgery?

Inhaling CBD using vape pens is the fastest method to benefit from the effects of CBD(25). However, vaping may damage the lungs(26).

Another quick way to ensure prompt delivery of CBD into your system is through the sublingual administration (under the tongue)(27).

You may start feeling the effects of CBD between 15 to 30 minutes when you take it sublingually. The chemical compound’s effects may last for 2 to 4 hours(28).

Most CBD tinctures or CBD oil products include calibrated droppers, which can be used to dispense the content straight into your mouth. Generally, CBD takes 15 to 30 minutes to take effect through this ingestion method(29).

On the other hand, CBD topical products are applied to the skin for localized relief. Even when some CBD topical products contain THC, which helps with pain relief, the components of these products do not enter the bloodstream. Hence, using CBD topicals should not cause impairment(30).

The onset time of CBD topicals is usually between 15 to 30 minutes, and its effect may last for 2 to 4 hours(31).

How Long Will CBD Help Before Surgery?

Bioavailability is the rate or extent a substance or drug becomes entirely available to its intended biological destinations(32).

A systematic review from the Frontiers in Pharmacology stated that the bioavailability of cannabidiol following smoking could be 31%(33).

Out of the 792 articles retrieved by the researchers, only 24 articles included pharmacokinetic parameters in humans(34).

The elimination of a drug’s half-life is a pharmacokinetic parameter. Half-life refers to a period where a substance in your system is reduced by 50%(35).

Drugs have varying half-lives. However, all of them follow this rule: after one half-life has passed, the other half of the initial drug amount is eliminated from the body(36).

Studies demonstrate that CBD’s half-life is between 1.4 and 10.9 hours following oromucosal spray, two to five days after consistent oral administration, 24 hours after an intravenous therapy, and 31 hours following smoking(37).

Intravenous therapy is a method where a drug or substance is administered directly into the veins.

Is CBD Oil Safe to Take Before Surgery?

According to the World Health Organization (WHO), CBD is generally well tolerated with a good safety profile(38).

However, if you are scheduled for a surgical procedure, make sure to inform your healthcare provider regarding CBD use.

Anesthesia is a complex combination of medications administered during surgery to prevent pain(39). Some drugs may interact with anesthetic medications, either positively or negatively(40).

Research shows that edibles and CBD may increase the amount of medication necessary to achieve an appropriate level of anesthesia(41). Thus, it is essential that you are honest and forthcoming during the pre-anesthesia interview.

Feel free to discuss with your anesthesiologist whether using CBD products like CBD oil before surgery is an excellent option for you.

In addition, ensure that you only choose the best CBD oil products from reputable CBD brands. You can read product reviews and ask for certificates of analysis from third-party laboratories to compare data on CBD potency and concentration.

When to Stop Taking CBD Before Surgery

Studies show that the half-life of CBD products, when taken orally, is around one to two days(42).

Studies suggest that CBD and THC may have a potent reaction with an enzyme system in the liver, resulting in a drug-to-drug interaction(43).

Given the potential effects of CBD oil and its components on other medications, make sure to talk to your physician to determine when to stop taking CBD before surgery.

When to Safely Resume Taking CBD Oil

The best way to determine whether it is already safe to resume taking CBD oil is to ask your physician.

Many patients who undergo a surgical procedure spend a couple of days on prescription painkillers that may interact with CBD.

The cytochrome P450 group is a family of liver enzymes that metabolize nearly 60% of the pharmaceutical drugs people consume(44).

CBD may inhibit the enzymes’ activities at high doses, increasing the effect and duration of the prescription drugs metabolized by the P450 group(45).

A 2020 clinical trial examined the effects of CBD hemp extract on opioid use and the indicators of quality life among chronic pain patients(46).

The results showed that CBD may significantly reduce opioid use and improve sleep quality and chronic pain among patients who used opioids for pain management(47).

Opioids work in the brain to produce various effects, including pain relief(48). However, caution is advised as higher doses of opioids may slow a person’s breathing and heart rate, leading to death.

The researchers of the 2020 clinical trial observed that using the CBD-rich extract allowed their patients to lessen or eliminate the use of opioids with significant improvement in their patients’ quality of life(49).

However, the clinical trial was only a prospective, single-arm cohort study for the possible role of cannabinoids like CBD as an alternative for opioids.

Hence, more longitudinal research is warranted to determine whether or not CBD can be used as an alternative for opioids.

Risks and Side Effects of Using CBD Before Surgery

Although CBD is often well tolerated in humans, it still carries some risks. CBD may also cause minor side effects, such as(50):

CBD may also interact with other medicines, like blood thinners.

Blood thinners prevent blood clots from forming and keep existing blood clots from getting larger(51).

Make sure to consult with your surgeon or healthcare provider regarding CBD use before undergoing any medical procedure.

Legality of CBD

The 2018 Farm Bill legalized the commercial use of industrial hemp on a federal level(52).

The bill stated that cannabis plants with less than 0.3% THC are federally legal in the U.S.

Still, it is recommended that you read and understand various state laws about CBD, especially when traveling, to avoid possible legal repercussions. Different states have varying regulations and statutes regarding CBD products.

Furthermore, the United States Food and Drug Administration (US FDA) has not recognized CBD as a medical treatment.

The only approved drug infused with CBD is Epidiolex. Epidiolex is an oral CBD solution to help with seizures associated with rare and severe forms of childhood epilepsy(53).

FAQs

  1. How can CBD help before surgery?

CBD has anti-anxiety and analgesic properties(54). People who will undergo surgery may find these therapeutic effects helpful.

Still, it is best to consult with your physician should you wish to use CBD or other supplements before a medical procedure.

  1. What evidence or research exists to say that CBD helps before surgery?

CBD has purported health benefits that may help relieve chronic pain, anxiety, and addiction(55). It also has antioxidative and anti-inflammatory properties(56).

According to a survey, 29% of patients with a history of spine surgery used CBD before their surgical procedure. About 63.0% of CBD users with spine-related pain said they would recommend cannabidiol to a friend for pain relief(57).

  1. Is there any evidence that CBD can make surgery worse?

Currently, no research suggests CBD’s potential role in making surgical procedures worse.

However, an animal study using a laboratory rat examined CBD’s impact on isoflurane anesthesia(58).

The results indicated that the impact of CBD on the course of isoflurane anesthesia may depend on the dose. Additionally, CBD may reduce the induction time(59).

  1. Will CBD interact with any current medication I may be taking before surgery?

CBD may interact with any current medication you may be taking before surgery.

CBD may interact with blood thinners(60). The chemical compound may also interact with substances that use the cytochrome P450 enzyme system, such as(61):

  • Steroids

  • Antibiotics

  • Antipsychotics

  • Antidepressants

  • Anesthetics

Cytochrome P450 refers to a superfamily of liver enzymes.

A study showed that edibles and CBD may increase the amount of medication necessary to achieve an appropriate level of anesthesia(62).

  1. Are there other treatments I should consider alongside CBD before surgery?

You must inform your anesthesiologists before surgery if you are considering using CBD and other supplements. Medical professionals can advise you on what to do and what to take before your scheduled operation.

The American Society of Anesthesiologists suggests staying as healthy as you can be before any surgical procedure(63). Hence, you should eat right, get enough sleep, and be as active as you can.

Ensure to quit smoking because it can cause breathing problems and affect your recovery from surgery and anesthesia(64).

  1. Can I fail a drug test if I use CBD before surgery?

CBD is non-psychoactive(65), meaning the compound does not produce a euphoric feeling.

In addition, the oral administration of cannabidiol does not result in detectable THC blood concentrations(66). Thus, oral CBD administration alone should not result in a positive drug test.

  1. What is the dosage for using CBD before surgery?

The FDA has not recognized CBD as a form of medication. Hence, there is no official CBD dosage guideline available before surgery.

According to a review on CBD’s safety and side effects, high doses and chronic use of CBD up to 1,500mg per day are well tolerated in humans(67).

  1. What are the potential side effects of CBD?

CBD carries some risks and minor side effects, such as diarrhea, dry mouth, drowsiness, reduced appetite, and fatigue(68).

  1. Is CBD oil safe to take before the surgery?

CBD is relatively safe(69). While results from studies are promising, it is still imperative to consult your physician regarding the use of CBD oil before surgery. More research is warranted to prove CBD’s long-term safety.

  1. Is CBD legal? 

CBD is legal in some states like Colorado. The state also inspects and regulates all hemp manufacturing operations within their territory to ensure the safety and optimal wellness of CBD consumers(70).

  1. Cannabidiol (CBD)-What We Know and What We Don’t
    https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476
  2. The Impact of Cannabidiol on the Induction of Isoflurane Anesthesia and Recovery in Wistar Rats
    https://pubmed.ncbi.nlm.nih.gov/33998903/
  3. Isoflurane
    https://www.ncbi.nlm.nih.gov/books/NBK532957/
  4. The Impact of Cannabidiol on the Induction of Isoflurane Anesthesia and Recovery in Wistar Rats
    https://pubmed.ncbi.nlm.nih.gov/33998903/
  5. Ibid.
  6. The Endocannabinoid System, Our Universal Regulator
    https://www.jyi.org/2018-june/2018/6/1/the-endocannabinoid-system-our-universal-regulator
  7. Ibid.
  8. Cannabinoids and Pain: New Insights From Old Molecules
    https://www.frontiersin.org/articles/10.3389/fphar.2018.01259/full
  9. Cannabidiol (CBD)-What We Know and What We Don’t
    https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476
  10. Antioxidative and Anti-Inflammatory Properties of Cannabidiol
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7023045/
  11. Prevalence of Cannabidiol Use in Patients With Spine Complaints: Results of an Anonymous Survey
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8375682/
  12. Ibid.
  13. Ibid.
  14. Ibid.
  15. Research Shows Pain-Relieving Effects of CBD
    https://www.sciencedaily.com/releases/2021/04/210423130221.htm
  16. Placebo Effect
    https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/placebo-effect
  17. Placebo-Controlled Trials in Surgery
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998723/
  18. Anticoagulant Effects of a Cannabis Extract in an Obese Rat Model
    https://pubmed.ncbi.nlm.nih.gov/16644197/
  19. Ibid.
  20. What Is Marijuana?
    https://www.drugabuse.gov/publications/research-reports/marijuana/what-marijuana
  21. Cannabidiol, Cannabinol and Their Combinations Act As Peripheral Analgesics in a Rat Model of Myofascial Pain
    https://pubmed.ncbi.nlm.nih.gov/31158702/
  22. Cannabinol
    https://pubchem.ncbi.nlm.nih.gov/compound/Cannabinol
  23. Cannabidiol, Cannabinol and Their Combinations Act As Peripheral Analgesics in a Rat Model of Myofascial Pain
    https://pubmed.ncbi.nlm.nih.gov/31158702/
  24. Cannabidiol Prescription in Clinical Practice: An Audit on the First 400 Patients in New Zealand
    https://bjgpopen.org/content/4/1/bjgpopen20X101010
  25. How to Safely Use CBD: Should You Inhale, Spray, Apply, or Eat It?
    https://www.consumerreports.org/cbd/how-to-use-cbd-inhale-spray-apply-eat/
  26. Is It Safe to Vape CBD?
    https://www.consumerreports.org/cbd/is-it-safe-to-vape-cbd/
  27. Fast Dissolving Sublingual Films of Ondansetron Hydrochloride: Effect of Additives on in vitro Drug Release and Mucosal Permeation
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2964757/
  28. Healing With CBD, page. 192.
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
  29. How to Safely Use CBD: Should You Inhale, Spray, Apply, or Eat It?
    https://www.consumerreports.org/cbd/how-to-use-cbd-inhale-spray-apply-eat/
  30. Healing With CBD, page. 210.
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
  31. Healing With CBD, page. 193.
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
  32. Drug Bioavailability
    https://www.ncbi.nlm.nih.gov/books/NBK557852/
  33. A Systematic Review on the Pharmacokinetics of Cannabidiol in Humans
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6275223/
  34. Ibid.
  35. Half-Life
    https://www.ncbi.nlm.nih.gov/books/NBK554498/
  36. Ibid.
  37. A Systematic Review on the Pharmacokinetics of Cannabidiol in Humans
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6275223/
  38. Cannabidiol (CBD)
    https://www.who.int/medicines/access/controlled-substances/CannabidiolCriticalReview.pdf
  39. Anesthetic Considerations for Patients Under the influence of Marijuana and/or Cannabidiol: Anesthesia Interactions and Implications
    https://dune.une.edu/cgi/viewcontent.cgi?article=1023&context=na_capstones
  40. Ibid.
  41. Ibid.
  42. Cannabidiol: Promise and Pitfalls
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189631/
  43. Drug-Drug Interactions as a Result of Co-administering Δ 9-THC and CBD With Other Psychotropic Agents
    https://pubmed.ncbi.nlm.nih.gov/29082802/
  44. Healing With CBD, page 114.
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
  45. Healing With CBD, page 115.
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
  46. Evaluation of the Effects of CBD Hemp Extract on Opioid Use and Quality of Life Indicators in Chronic Pain Patients: A Prospective Cohort Study
    https://pubmed.ncbi.nlm.nih.gov/31711352/
  47. Ibid.
  48. What Are Opioids?
    https://www.hopkinsmedicine.org/opioids/what-are-opioids.html
  49. Evaluation of the Effects of CBD Hemp Extract on Opioid Use and Quality of Life Indicators in Chronic Pain Patients: A Prospective Cohort Study
    https://pubmed.ncbi.nlm.nih.gov/31711352/
  50. What Are the Benefits of CBD — And Is It Safe to Use?
    https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/is-cbd-safe-and-effective/faq-20446700
  51. Blood Thinners
    https://medlineplus.gov/bloodthinners.html
  52. H.R.2 – Agriculture Improvement Act of 2018
    https://www.congress.gov/bill/115th-congress/house-bill/2/text
  53. FDA Approves First Drug Comprised of an Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy
    https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-comprised-active-ingredient-derived-marijuana-treat-rare-severe-forms
  54. Cannabidiol Prescription in Clinical Practice: An Audit on the First 400 Patients in New Zealand
    https://bjgpopen.org/content/4/1/bjgpopen20X101010
  55. Cannabidiol (CBD)-What We Know and What We Don’t
    https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476
  56. Antioxidative and Anti-Inflammatory Properties of Cannabidiol
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7023045/
  57. Prevalence of Cannabidiol Use in Patients With Spine Complaints: Results of an Anonymous Survey
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8375682/
  58. The Impact of Cannabidiol on the Induction of Isoflurane Anesthesia and Recovery in Wistar Rats
    https://pubmed.ncbi.nlm.nih.gov/33998903/
  59. Ibid.
  60. What Are the Benefits of CBD — And Is It Safe to Use?
    https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/is-cbd-safe-and-effective/faq-20446700
  61. Healing With CBD, pages 115-116.
    https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
  62. Anesthetic Considerations for Patients Under the influence of Marijuana and/or Cannabidiol: Anesthesia Interactions and Implications
    https://dune.une.edu/cgi/viewcontent.cgi?article=1023&context=na_capstones
  63. Preparing for Surgery: Checklist
    https://www.asahq.org/madeforthismoment/preparing-for-surgery/prep/preparing-for-surgery-checklist/
  64. Ibid.
  65. Cannabidiol and Other Non-Psychoactive Cannabinoids for Prevention and Treatment of Gastrointestinal Disorders: Useful Nutraceuticals?
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246936/
  66. FAQs About Cannabidiol (CBD)
    https://norml.org/marijuana/fact-sheets/faqs-about-cannabidiol-cbd/
  67. Safety and Side Effects of Cannabidiol, a Cannabis sativa Constituent
    https://pubmed.ncbi.nlm.nih.gov/22129319/
  68. What Are the Benefits of CBD — And Is It Safe to Use?
    https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/is-cbd-safe-and-effective/faq-20446700
  69. Cannabidiol (CBD)
    https://www.who.int/medicines/access/controlled-substances/CannabidiolCriticalReview.pdf
  70. Hemp in Food
    https://cdphe.colorado.gov/hemp-food
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Written by 

Stanley Clark

Stanley Clark is a community development volunteer and writer. He had worked on several commercials, events, and campaigns before writing full-time in the area of natural health and wellness. He has a particular interest in reviewing CBD brands for their...

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