Literature DB >> 30170713

Should Cannabinoids Be Added to Multimodal Pain Regimens After Total Hip and Knee Arthroplasty?

Thomas R Hickernell1, Akshay Lakra1, Ari Berg1, Herbert J Cooper1, Jeffrey A Geller1, Roshan P Shah1.   

Abstract

BACKGROUND: This study investigated the effects of dronabinol on pain, nausea, and length of stay following total joint arthroplasty (TJA).
METHODS: We retrospectively compared 81 consecutive primary TJA patients who received 5 mg of dronabinol twice daily in addition to a standard multimodal pain regimen with a matched cohort of 162 TJA patients who received only the standard regimen. A single surgeon performed all surgeries. Patient demographics, length of stay, opioid morphine equivalents (MEs) consumed, reports of nausea/vomiting, discharge destination, distance walked in physical therapy, and visual analog scale pain scores were collected for both groups. Student's t-tests as well as chi-square or Mann-Whitney U-tests were used for statistical comparisons.
RESULTS: There were no significant differences between the 2 groups for age, gender, body mass index, American Society of Anesthesiologists score, anesthesia type, visual analog scale scores, distance walked with physical therapy, discharge disposition, or episodes of nausea/vomiting. The mean length of stay in the dronabinol group was significantly shorter at 2.3 ± 0.9 days versus 3.0 ± 1.2 days in the control group (P = .02). In the context of a shorter stay, the dronabinol group consumed significantly fewer total MEs (252.5 ± 131.5 vs 313.3 ± 185.4 mg, P = .0088). Although the dronabinol group consumed fewer MEs per day and per length of stay on average, neither of these achieved statistical significance. No side effects of dronabinol were reported.
CONCLUSION: These findings suggest that further investigation into the role of cannabinoid medications for non-opioid pain control in the post-arthroplasty patient may hold merit.
Copyright © 2018 Elsevier Inc. All rights reserved.

Entities:  

Keywords:  cannabinoids; dronabinol; total hip arthroplasty; total joint arthroplasty; total knee arthroplasty

Mesh:

Substances:

Year:  2018        PMID: 30170713     DOI: 10.1016/j.arth.2018.07.027

Source DB:  PubMed          Journal:  J Arthroplasty        ISSN: 0883-5403            Impact factor:   4.757


  14 in total

1.  Preoperative cannabis use does not increase opioid utilization following primary total hip arthroplasty in a propensity matched analysis.

Authors:  Christian B Ong; Simarjeet Puri; Juliana Lebowitz; Yu-Fen Chiu; Alejandro Gonzalez Della Valle; Alexandra Sideris; Brian P Chalmers
Journal:  Arch Orthop Trauma Surg       Date:  2022-09-21       Impact factor: 2.928

2.  The Ramifications of Opioid Utilization and Outcomes of Alternative Pain Control Strategies for Total Knee Arthroplasties.

Authors:  Kevin Berardino; Austin H Carroll; Robert Ricotti; Daniel Popovsky; Matthew D Civilette; Ivan Urits; Omar Viswanath; William F Sherman; Alan D Kaye
Journal:  Orthop Rev (Pavia)       Date:  2022-08-30

Review 3.  Analyzing the Impact of Cannabinoids on the Treatment of Spinal Disorders.

Authors:  Rohan M Shah; Anjay Saklecha; Alpesh A Patel; Srikanth N Divi
Journal:  Curr Rev Musculoskelet Med       Date:  2022-02-08

4.  Cannabinoids and orthopedic surgery: a systematic review of therapeutic studies.

Authors:  Bradley J Vivace; Allyson N Sanders; Steven D Glassman; Leah Y Carreon; Joseph L Laratta; Jeffrey L Gum
Journal:  J Orthop Surg Res       Date:  2021-01-14       Impact factor: 2.359

5.  Prevalence of Cannabinoid Use in Patients With Hip and Knee Osteoarthritis.

Authors:  David G Deckey; Nina J Lara; Matthew T Gulbrandsen; Jeffrey D Hassebrock; Mark J Spangehl; Joshua S Bingham
Journal:  J Am Acad Orthop Surg Glob Res Rev       Date:  2021-02-02

6.  Prevalence of Cannabinoid (CBD) Use in Orthopaedic Sports Medicine Patients.

Authors:  David G Deckey; Matthew Doan; Jeffrey D Hassebrock; Karan A Patel; Kostas Economopoulos; John M Tokish; Joshua S Bingham; Anikar Chhabra
Journal:  Orthop J Sports Med       Date:  2022-04-05

Review 7.  Cannabinoids in the Management of Acute Pain: A Systematic Review and Meta-analysis.

Authors:  Aaron Gazendam; Nicholas Nucci; Kyle Gouveia; Hassaan Abdel Khalik; Luc Rubinger; Herman Johal
Journal:  Cannabis Cannabinoid Res       Date:  2020-12-15

Review 8.  Cannabinoid Receptors: An Update on Cell Signaling, Pathophysiological Roles and Therapeutic Opportunities in Neurological, Cardiovascular, and Inflammatory Diseases.

Authors:  Dhanush Haspula; Michelle A Clark
Journal:  Int J Mol Sci       Date:  2020-10-17       Impact factor: 5.923

9.  Opioid Use Is Reduced in Patients Treated with NSAIDs After Arthroscopic Bankart Repair: A Randomized Controlled Study.

Authors:  Kamali A Thompson; David Klein; Michael J Alaia; Eric J Strauss; Laith M Jazrawi; Kirk A Campbell
Journal:  Arthrosc Sports Med Rehabil       Date:  2020-12-27

10.  Postoperative pain treatment with transmuscular quadratus lumborum block and fascia iliaca compartment block in patients undergoing total hip arthroplasty: a randomized controlled trial.

Authors:  Qin Xia; Wenping Ding; Chao Lin; Jiayi Xia; Yahui Xu; Mengxing Jia
Journal:  BMC Anesthesiol       Date:  2021-07-10       Impact factor: 2.217

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