NEMA Research, Inc., Naples, FL, USA.
NEMA Research, Inc., Naples, FL, USA -
Minerva Anestesiol. 2018 Aug;84(8):955-969. doi: 10.23736/S0375-9393.18.12287-5. Epub 2018 Jan 16.
Cannabinoids appear to possess many potential medical uses, which may extend to pain control. A narrative review of the literature has found a variety of studies testing botanical and synthetic cannabinoids in different pain syndromes (acute pain, cancer pain, chronic noncancer pain, fibromyalgia pain, migraine, neuropathic pain, visceral pain, and others). Results from these studies are mixed; cannabinoids appear to be most effective in controlling neuropathic pain, allodynia, medication-rebound headache, and chronic noncancer pain, but do not seem to offer any advantage over nonopioid analgesics for acute pain. Cannabinoids seem to work no better than placebo for visceral pain and conferred only modest analgesic effect in cancer pain. Cannabinoids do many good things - they appear to be effective in treating certain types of pain without the issues of tolerance associated with opioids. Negatively, marijuana currently has a very murky legal status all over the world - laws regulating its use are inconsistent and in flux. Thus, both patients and prescribers may be unsure about whether or not it is an appropriate form of pain control. Cannabinoid-based analgesia has been linked to potential memory deficits and cognitive impairment. A great deal more remains to be elucidated about cannabinoids which may emerge to play an important role in the treatment of neuropathic and possibly other painful conditions. There remains a great deal more to learn about the role of cannabinoids in pain management.
大麻素似乎具有许多潜在的医疗用途，可能扩展到疼痛控制。对文献的叙述性回顾发现，各种研究都在不同的疼痛综合征（急性疼痛、癌症疼痛、慢性非癌症疼痛、纤维肌痛、偏头痛、神经病理性疼痛、内脏疼痛等）中测试植物性和合成大麻素。这些研究的结果喜忧参半；大麻素似乎在控制神经病理性疼痛、感觉过敏、药物性反弹头痛和慢性非癌症疼痛方面最有效，但在急性疼痛方面似乎并不优于非阿片类镇痛药。大麻素似乎对内脏疼痛的效果并不优于安慰剂，对癌症疼痛的镇痛效果也只有适度的改善。大麻素确实有很多好处——它们似乎可以有效治疗某些类型的疼痛，而不会产生与阿片类药物相关的耐受问题。不利的是，大麻在全世界的法律地位非常模糊——监管其使用的法律不一致且不断变化。因此，患者和开处方者可能都不确定它是否是一种合适的疼痛控制形式。基于大麻素的镇痛与潜在的记忆缺陷和认知障碍有关。关于大麻素，还有很多需要阐明的地方，它可能在治疗神经病理性疼痛和可能的其他疼痛疾病方面发挥重要作用。关于大麻素在疼痛管理中的作用，还有很多需要学习的地方。
