Cannabis-associated hyperalgesia and reduced local anesthetic efficacy in oral surgery: A case report

Cannabis use has increased significantly in recent years, yet its impact on local anesthetic efficacy in oral surgery remains poorly understood. This report analyzes the case of a 34-year-old male with history of chronic cannabis use who exhibited a hyperalgesic pain response and difficulty achieving adequate anesthesia during dental extraction in spite of standard anesthetic techniques. This atypical presentation may be explained by cannabis-associated alterations in pain pathways, including hyperalgesia related to chronic cannabinoid exposure, pharmacokinetic, and hemodynamic effects. This case highlights the potential impact of cannabis on pain perception and anesthetic response, underscoring the need for clinicians to consider cannabis use when planning anesthesia and to adapt management strategies accordingly.