大麻素在疼痛管理中作用的重新评估。

Reassessment of the role of cannabinoids in the management of pain.

作者信息

Beaulieu Pierre, Ware Mark

机构信息

Department of Anesthesiology and Pharmacology, University of Montréal, Montréal, Québec, Canada.

出版信息

Curr Opin Anaesthesiol. 2007 Oct;20(5):473-7. doi: 10.1097/ACO.0b013e3282efd175.

Abstract

PURPOSE OF REVIEW

The aim of this article is to assess the role of cannabinoids in the treatment of acute and chronic pain in humans.

RECENT FINDINGS

Very few clinical trials looking at the analgesic effects of cannabinoids in the acute pain settings have been performed. Three recent studies have evaluated the oral administration of synthetic cannabinoids in postoperative pain. At low doses cannabinoids are not different from placebo, whereas at high doses they may be associated with adverse effects or even worsening of pain intensity. In chronic pain patients, the safety and analgesic efficacy of a number of cannabinoid compounds have recently been evaluated in several clinical trials in several chronic pain conditions. While the small size of the trials and the relatively short duration of follow-up limits broad generalization, to date there is increasing evidence that cannabinoids are safe and effective for refractory chronic pain conditions including neuropathic pain associated with multiple sclerosis, rheumatoid arthritis, and peripheral neuropathy associated with HIV/AIDS.

SUMMARY

The precise role of cannabinoids in pain treatment still needs further evaluation. Cannabinoid compounds may be more effective in the context of chronic neuropathic pain than for the management of acute pain.

摘要

综述目的

本文旨在评估大麻素在治疗人类急慢性疼痛中的作用。

最新研究发现

针对大麻素在急性疼痛环境中的镇痛作用开展的临床试验极少。最近有三项研究评估了合成大麻素口服给药对术后疼痛的影响。低剂量时,大麻素与安慰剂无异,而高剂量时可能会出现不良反应,甚至疼痛强度加重。在慢性疼痛患者中,最近在多项针对多种慢性疼痛状况的临床试验中评估了多种大麻素化合物的安全性和镇痛效果。尽管试验规模较小且随访时间相对较短限制了广泛推广,但迄今为止,越来越多的证据表明,大麻素对难治性慢性疼痛状况是安全有效的,这些状况包括与多发性硬化症相关的神经性疼痛、类风湿性关节炎以及与HIV/AIDS相关的周围神经病变。

总结

大麻素在疼痛治疗中的确切作用仍需进一步评估。大麻素化合物在慢性神经性疼痛方面可能比在急性疼痛管理方面更有效。

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