Bradley J Vivace1,2, Allyson N Sanders3, Steven D Glassman4, Leah Y Carreon4, Joseph L Laratta4, Jeffrey L Gum4. 1. University of Louisville School of Medicine, 500 South Preston Street, Louisville, KY, USA. bjviva01@louisville.edu. 2. Norton Leatherman Spine Center, 210 E Gray Street, Suite 900, Louisville, KY, USA. bjviva01@louisville.edu. 3. University of Louisville School of Medicine, 500 South Preston Street, Louisville, KY, USA. 4. Norton Leatherman Spine Center, 210 E Gray Street, Suite 900, Louisville, KY, USA.
Abstract
BACKGROUND: Recent work has shed light on the potential benefits of cannabinoids for multimodal pain control following orthopedic procedures. The objective of this review was to summarize the available evidence of analgesic and opioid-sparing effects cannabinoids have in orthopedic surgery and identify adverse events associated with their use. METHODS: A systematic review of the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines including PubMed, EMBASE, MEDLINE, PsycINFO, and Google Scholar was performed to include all primary, therapeutic studies published on the use of cannabis, and cannabis-derived products in orthopedic surgery. RESULTS: The literature review returned 4292 citations. Thirteen publications were found to meet inclusion criteria. Four randomized controlled trials were evaluated while the remaining studies were of quasi-experimental design. CONCLUSION: Research on cannabinoids in orthopedic surgery is mostly of a quasi-experimental nature and is mainly derived from studies where orthopedics was not the primary focus. The overall results demonstrate potential usefulness of cannabinoids as adjunctive analgesics and in mitigating opioid use. However, the current evidence is far from convincing. There is a need to produce rigorous evidence with well-designed randomized controlled trials specific to orthopedic surgery to further establish these effects.
BACKGROUND: Recent work has shed light on the potential benefits of cannabinoids for multimodal pain control following orthopedic procedures. The objective of this review was to summarize the available evidence of analgesic and opioid-sparing effects cannabinoids have in orthopedic surgery and identify adverse events associated with their use. METHODS: A systematic review of the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines including PubMed, EMBASE, MEDLINE, PsycINFO, and Google Scholar was performed to include all primary, therapeutic studies published on the use of cannabis, and cannabis-derived products in orthopedic surgery. RESULTS: The literature review returned 4292 citations. Thirteen publications were found to meet inclusion criteria. Four randomized controlled trials were evaluated while the remaining studies were of quasi-experimental design. CONCLUSION: Research on cannabinoids in orthopedic surgery is mostly of a quasi-experimental nature and is mainly derived from studies where orthopedics was not the primary focus. The overall results demonstrate potential usefulness of cannabinoids as adjunctive analgesics and in mitigating opioid use. However, the current evidence is far from convincing. There is a need to produce rigorous evidence with well-designed randomized controlled trials specific to orthopedic surgery to further establish these effects.
Entities:
Keywords:
Analgesia; Arthroplasty; Cannabinoids; Multimodal pain control; Opioids; Orthopedic surgery
Authors: Jonathan A C Sterne; Jelena Savović; Matthew J Page; Roy G Elbers; Natalie S Blencowe; Isabelle Boutron; Christopher J Cates; Hung-Yuan Cheng; Mark S Corbett; Sandra M Eldridge; Jonathan R Emberson; Miguel A Hernán; Sally Hopewell; Asbjørn Hróbjartsson; Daniela R Junqueira; Peter Jüni; Jamie J Kirkham; Toby Lasserson; Tianjing Li; Alexandra McAleenan; Barnaby C Reeves; Sasha Shepperd; Ian Shrier; Lesley A Stewart; Kate Tilling; Ian R White; Penny F Whiting; Julian P T Higgins Journal: BMJ Date: 2019-08-28
Authors: Epifanio Mondello; Domenico Quattrone; Luigi Cardia; Giuseppe Bova; Raffaella Mallamace; Alessia A Barbagallo; Cristina Mondello; Carmen Mannucci; Martina Di Pietro; Vincenzo Arcoraci; Gioacchino Calapai Journal: J Pain Res Date: 2018-09-06 Impact factor: 3.133