From the Departments of *Anesthesiology, Perioperative and Pain Medicine, †Neuroscience, and ‡Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY; and §Icahn School of Medicine at Mount Sinai, New York, NY.
Reg Anesth Pain Med. 2017 Sep/Oct;42(5):652-659. doi: 10.1097/AAP.0000000000000654.
Cannabinoids have an expanding presence in medicine. Perioperative patients' perceptions of the effectiveness of these compounds, and acceptance if prescribed for pain, have not been previously described. Our primary objective was to describe patients' beliefs regarding the potential effectiveness of cannabinoids for the treatment of acute and chronic pain, as well as gauge patient acceptance of these compounds if prescribed by a physician. In addition, demographic and pain history data were collected to elucidate the predictors of the aforementioned patient attitudes. Secondarily, we sought to characterize the subgroup of patients who reported marijuana use. Predictors of marijuana use, effectiveness, and adverse effects were also reported for this subgroup.
An anonymous questionnaire was administered to 501 patients in the preoperative registration area at Mount Sinai Hospital, New York, New York. The questionnaire was designed to collect data on patient demographics, presence of pain, pain severity, use of pain medication, history of illicit-drug use, tobacco use, cannabis use, patient beliefs about the potential effectiveness of marijuana for acute and chronic pain and their willingness to use cannabis for pain, if prescribed by a physician. Normality of distributions for continuous variables was assessed with skewness and kurtosis measures. A logistic regression model was used to assess the demographic and medical characteristics of marijuana users compared with nonusers. The effectiveness of marijuana in dealing with pain and adverse effects associated with its use were examined using exploratory principal component analysis.
More than 80% of this cohort of preoperative patients believed that marijuana could be at least somewhat effective for the treatment of pain after surgery and would be willing to use cannabinoid compounds if prescribed by their physician. Predictors of positive attitudes toward marijuana included history of marijuana use, pain history, and being a marijuana nonuser of white race. Approximately 27% of the respondents reported a history of marijuana use. Younger patients, those with higher levels of pain in the last 24 hours, and those who found standard therapies to be less effective for their pain were more likely to use marijuana.
Patients generally believe that marijuana could be at least somewhat effective for the management of pain and are willing to use cannabinoid compounds for this indication, if prescribed by a physician.
大麻素在医学领域的应用日益广泛。目前尚未有研究描述围手术期患者对这些化合物有效性的看法，以及如果开具用于治疗疼痛的处方，患者对这些化合物的接受程度。本研究的主要目的是描述患者对大麻素治疗急性和慢性疼痛的潜在有效性的看法，并评估如果医生开具这些药物，患者对其的接受程度。此外，还收集了人口统计学和疼痛史数据，以阐明上述患者态度的预测因素。其次，我们试图对报告大麻使用的患者亚组进行特征描述。还报告了该亚组中大麻使用、有效性和不良反应的预测因素。
在纽约西奈山医院的术前登记区，向 501 名患者发放了匿名问卷。问卷旨在收集患者人口统计学数据、疼痛存在情况、疼痛严重程度、疼痛药物使用情况、非法药物使用史、烟草使用情况、大麻使用情况、患者对大麻治疗急性和慢性疼痛的潜在有效性的看法以及如果医生开具处方，他们对使用大麻治疗疼痛的意愿。使用偏度和峰度测量评估连续变量的分布正态性。使用逻辑回归模型比较大麻使用者和非使用者的人口统计学和医学特征。使用探索性主成分分析检查大麻在缓解疼痛方面的有效性和使用相关不良反应。
该队列的大多数术前患者认为大麻至少对术后疼痛的治疗可能有一定效果，如果医生开具处方，他们愿意使用大麻素化合物。对大麻持积极态度的预测因素包括大麻使用史、疼痛史和非白人种族。约 27%的受访者报告有大麻使用史。年轻患者、过去 24 小时内疼痛程度较高的患者以及认为标准疗法对其疼痛效果较差的患者更有可能使用大麻。
患者普遍认为大麻至少对疼痛管理可能有一定效果，如果医生开具处方，他们愿意使用大麻素化合物用于该适应证。
