Cannabis, Kratom and Kariyat: Issues of Concern in Perianesthetic Care

Abstract

Cannabis, Kratom, and Kariyat have long been used as herbal medicine. Cannabinoids in Cannabis have effects on moods, pain sensation and memories. It is often administered to end-stage patients as comforting and palliative treatment. While Kratom yields Mitragynine which has analgesic properties like Morphine, it is frequently used to counteract withdrawal symptoms after giving up Cannabis and Opium. Interestingly, Andrographolide in Kariyat can alleviate the acute phase of upper respiratory tract infection. Since the period of new pandemic prevalence of disease and the possibility to take these herbs over the counter, they are consequently consumed as alternative medicine with carelessness and negligence. As Cannabis, Kratom, and Kariyat have an effect on inhibiting enzyme Cytochrome P-450 in the liver; therefore, the drug interaction with other preparations particularly the anesthetics results in the synergistic, additive and some adverse effects. Thus, anesthesia personnel have to handle these vulnerable subjects like ones with the problem of chronic alcoholism or drug addiction. For example, patients must be checked up on laboratory tests including liver, kidney and coagulation profiles. Moreover, they should be advised to stop Marijuana 72 hours prior to surgery owing to its toxicity and adverse effects have the lookalike signs and symptoms of clinically anesthetic manifestation.