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Canadian Journal of Anesthesia

, Volume 53, Issue 8, pp 769–775 | Cite as

Effects of nabilone, a synthetic cannabinoid, on postoperative pain

  • Pierre Beaulieu
Regional Anesthesia and Pain

Abstract

Purpose

Cannabinoids have been shown to have analgesic properties in animal studies, but a potential role for these drugs in acute pain management has not been established. It was hypothesized that nabilone, an oral cannabinoid synthetic tetrahydrocannabinol analogue, decreases morphine consumption, pain scores, nausea and vomiting following major surgery.

Methods

A double-blind, randomized, placebo-controlled, parallel-group pilot trial compared the effects of two different doses, 1 mg (n = 11) and 2 mg (n = 9) of nabilone, ketoprofen 50 mg (n = 11) or placebo (n = 10), given at eight-hour intervals for 24 hr. Outcomes included morphine consumption, pain scores and emesis after major surgery. Secondary outcomes included patient tolerability of the study medication.

Results

Forty-one patients (mean age 52 ± 2 yr) undergoing gynecologic (46%), orthopedic (44%), or other (10%) surgery were recruited. Cumulative 24-hr morphine consumption was not different between the four groups, but pain scores at rest and on movement were significantly higher in the 2 mg nabilone group compared to the other groups. There were no significant differences between groups with respect to episodes of nausea and vomiting, quality of sleep, sedation, euphoria, pruritus, or the number and severity of adverse events. No serious adverse event was recorded.

Conclusions

Contrary to the main hypothesis, high dose nabilone in the presence of morphine patient controlled analgesia is associated with an increase in pain scores in patients undergoing major surgery.

Keywords

Morphine Pain Score Ketoprofen Parecoxib Morphine Consumption 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Les effets de la nabilone, un cannabinoïde synthétique, sur la douleur postopératoire

Résumé

Objectif

Les propriétés analgésiques des cannabinoïdes ont été démontrées chez des animaux, mais leur rôle possible sur le contrôle de la douleur aiguë n’a pas été établi. Notre hypothèse voulait que la nabilone, analogue synthétique oral du cannabinoïde tétrahydrocannabinol, diminue la consommation de morphine, les scores de douleur, les nausées et les vomissements à la suite d’une opération chirurgicale majeure.

Méthode

Dans une étude pilote de groupes parallèles, randomisée, à double insu et contrôlée contre placebo, les effets de deux doses de nabilone, 1 mg (n = 11) et 2 mg (n = 9), de 50 mg de kétoprofène (n = 11) ou d’un placebo (n = 10), administrés à 8 h d’intervalle pendant 24 h, ont été comparés. La consommation de morphine, les scores de douleur et les vomissements ont été notés après une chirurgie majeure. Les effets de la médication sur le patient étaient également étudiés.

Résultats

Quarante et un patients (moyenne d’âge de 52 ± 2 ans) subissant une intervention gynécologique (46 %), orthopédique (44 %) ou autre (10 %) ont été recrutés. La consommation cumulative de morphine sur 24 h était similaire dans les quatre groupes, mais les scores de douleur au repos et au mouvement ont été significativement plus élevés dans le groupe nabilone 2 mg. Aucune différence intergroupe significative n’est apparue quant aux épisodes de nausées et de vomissements, la qualité du sommeil, la sédation, l’euphorie, le prurit ou le nombre et la sévérité des événements indésirables. Aucun incident sérieux n’a été enregistré.

Conclusion

Contrairement à notre hypothèse, une forte dose de nabilone, en présence de morphine administrée comme analgésie auto-contrôlée, est associée à une hausse des scores de douleur chez les patients qui subissent une chirurgie majeure.

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Copyright information

© Canadian Anesthesiologists 2006

Authors and Affiliations

  1. 1.Departments of Anesthesiology and PharmacologyFaculty of Medicine, Université de MontréalMontréalCanada
  2. 2.Department of AnesthesiologyCHUM — Hôtel-DieuMontréalCanada

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