Pediatric Pain and Palliative Care Service, Department of Women's and Children's Health, University Hospital, Padova, Italy.
Polistudium Srl, Milan, Italy.
Ital J Pediatr. 2021 Nov 21;47(1):229. doi: 10.1186/s13052-021-01179-1.
Medical cannabis may be a useful tool for managing treatment-resistant epilepsy and chronic pain, which affect many patients in pediatric palliative care (PPC); however, little evidence is available in this setting.
We aimed to describe a clinical experience in a setting where high-level evidence may not be obtained. We report our clinical experience in a pediatric palliative care department in Italy. Caregivers reported changes in intensity and frequency of pain and epilepsy events. Six patients received a titrated plant extract of cannabis sativa for 1 year. Only mild and transient adverse events occurred: drowsiness, euphoria, restlessness and tachycardia; the resolution was either spontaneous or obtained by modifying the administration schedule. Treatment was never discontinued. No overdoses occurred. All patients experienced seizures during the pre-treatment observation period, and obtained a reduction in seizure frequency, although with variable extent while receiving cannabis. In addition, a benefit on pain was observed, based on the caregiver's evaluation, and a reduction of analgesic use.
Our experience suggests that a titrated plant extract preparation of medical cannabis may be useful to control treatment-resistant pain and epilepsy in PPC patients.
医用大麻可能是治疗耐药性癫痫和慢性疼痛的有用工具，这些疾病影响着许多儿科姑息治疗（PPC）患者；然而，在这种情况下，几乎没有证据可用。
我们旨在描述在可能无法获得高级别证据的环境中的临床经验。我们报告了在意大利儿科姑息治疗科的临床经验。护理人员报告疼痛和癫痫发作的强度和频率发生变化。六名患者接受了大麻 sativa 的植物提取物的滴定治疗，为期 1 年。仅发生轻度和短暂的不良反应：嗜睡、欣快、不安和心动过速；解决方案要么是自发的，要么是通过修改给药时间表获得的。治疗从未停止过。没有发生药物过量。所有患者在治疗前观察期间均出现癫痫发作，并减少了癫痫发作频率，尽管在接受大麻治疗时程度不同。此外，根据护理人员的评估，观察到疼痛减轻，并且减少了镇痛药的使用。
我们的经验表明，医用大麻的植物提取物制剂可能有助于控制 PPC 患者的耐药性疼痛和癫痫。
