Primary ArthroplastyShould Cannabinoids Be Added to Multimodal Pain Regimens After Total Hip and Knee Arthroplasty?
Section snippets
Methods
This is a retrospective study approved by the institutional review board. All eligible patients had undergone unilateral primary TKA or primary THA between January 2015 and December 2017. Patients either received spinal or general anesthesia (if spinal was unobtainable) as per our standard of care clinical protocol. Additionally, 15 (18.5%) TKA patients in the dronabinol group and 19 (11.7%) TKA patients in the control group received an adductor canal block (P = .13). All adductor canal blocks
Results
There was no significant difference between the 2 groups for age, gender, BMI, American Society of Anesthesiologists scores, initial surgery, and anesthesia type. Mean age for the dronabinol group and the control group was 64.9 ± 9.9 years (range 45-88) and 62.5 ± 10.1 years (range 23.5-90), respectively. The dronabinol group was 65.4% female and the control group 63.5% female (P = .635). Mean BMI was 30.1 and 29.2 kg/m2 for the dronabinol and control groups, respectively (P = .281) (Table 2).
Discussion
The results of this study are encouraging. Patients undergoing THA and TKA who received dronabinol 5 mg twice per day consumed fewer total inpatient opioid medications in the context of shorter lengths of hospital stay, while performing equivalently in terms of other subjective and objective outcome measures in the acute post-operative period. A shorter LOS reflects an earlier satisfaction of discharge requirements, including pain control and function.
It is possible that the total MEs consumed
References (35)
Medical marijuana policies and hospitalizations related to marijuana and opioid pain reliever
Drug Alcohol Depend
(2017)- et al.
At the heart of the matter: the endocannabinoid system in cardiovascular function and dysfunction
Trends Pharmacol Sci
(2012) - et al.
Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related pain
J Pain Symptom Manage
(2010) - et al.
The analgesic effect of oral delta-9-tetrahydrocannabinol (THC), morphine, and a THC-morphine combination in healthy subjects under experimental pain conditions
Pain
(2003) - et al.
Lack of analgesic efficacy of oral δ-9-tetrahydrocannabinol in postoperative pain
Pain
(2003) - et al.
Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committee on Regional Anesthesia, Executive Committee, and Administrative Council
J Pain
(2016) Cannabidiol: swinging the marijuana pendulum from ‘weed’ to medication to treat the opioid epidemic
Trends Neurosci
(2017)- et al.
Early phase in the development of cannabidiol as a treatment for addiction: opioid relapse takes initial center stage
Neurotherapeutics
(2015) - et al.
A practical and natural taxonomy for Cannabis
Taxon
(1976) - et al.
Who is using cannabis as a medicine and why: an exploratory study
J Psychoactive Drugs
(2000)
The International Drug Control Conventions
16th International Society of Addiction Medicine Annual Meeting 2 – 6 October 2014
Alcohol Alcohol
Driving under the influence of Marijuana laws and the public’s health: public health and the law
J Law Med Ethics
Cannabinoids: medical implications
Ann Med
Marijuana à des fins médicales: réflexions pour l’anesthésiologiste et le médecin spécialiste de la douleur
Can J Anesth
Molecular characterization of a peripheral receptor for cannabinoids
Nature
Cannabinoids and the digestive tract
Handb Exp Pharmacol
Cited by (0)
One or more of the authors of this paper have disclosed potential or pertinent conflicts of interest, which may include receipt of payment, either direct or indirect, institutional support, or association with an entity in the biomedical field which may be perceived to have potential conflict of interest with this work. For full disclosure statements refer to https://doi.org/10.1016/j.arth.2018.07.027.