Etomidate Dosing and Recovery in Cannabis Users in Wada Test
Bibliographic record
Abstract
INTRODUCTION: The Wada test involves the intracarotid injection of anesthetics-commonly etomidate-to transiently anesthetize one hemisphere for assessing language and memory dominance during presurgical evaluation. However, evidence on guiding intracarotid etomidate remains limited. This retrospective study aimed to investigate cannabis use and other factors such as body weight that may influence the intracarotid etomidate dosing regimen. METHODS: We included all adults who underwent the Wada test at our institution between February 2012 and January 2024. The primary exposure was cannabis use. The primary outcome was the total etomidate dose, defined as the cumulative amount (mg) required to achieve and maintain hemispheric anesthesia during each injection. Multivariable linear regression analysis was performed to assess the association between active cannabis use and total etomidate dose. We also compared the pharmacodynamic characteristics between cannabis users and nonusers. RESULTS: A total of 47 patients with 98 intracarotid etomidate injections were included. Active cannabis use was significantly associated with an increased total etomidate dose per injection (adjusted β=0.99, 95% CI: 0.03-1.9, P =0.04). Factors such as age, sex, body weight, and a history of alcoholism or other drug abuse were not significantly associated with the dose. Cannabis users experienced faster recovery, with a shorter time from the initial bolus to motor strength recovery (624 s [441 to 808] vs. 750 s [564 to 908], P =0.01). DISCUSSION: Our findings suggest that cannabis use is associated with a higher dose requirement of intracarotid etomidate and faster recovery times following cessation of the etomidate infusion.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".