Sun Naiyi, Cunha Natasha, Amar Shawnee, Brown Stephen
Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, Ontario, Canada.
Can J Pain. 2022 Nov 28;6(1):225-231. doi: 10.1080/24740527.2022.2132138. eCollection 2022.
The prevalence of chronic pain in children and adolescents is high. In some patients, it can be severe and refractory to conventional treatment options. There is increasing interest in the use of cannabinoids for therapeutic purposes in children and adolescents. Nabilone, a synthetic cannabinoid, is approved in Canada for the treatment of nausea and vomiting associated with chemotherapy. It can also be used off label for treatment of chronic pain.
This study aims to characterize the use of nabilone for severe chronic pain in a pediatric population.
This is a retrospective cohort study of patients 18 years or younger who were prescribed nabilone for chronic pain in a tertiary multidisciplinary pediatric chronic pain clinic between July 1, 2013, and June 30, 2017.
During the 4-year study period, we screened the charts of 507 patients and identified a total of 28 patients (5.5%) who were treated with nabilone as part of their chronic pain treatment. Common indications for nabilone treatment include mixed neuropathic/nociceptive pain, abdominal pain, neuropathic pain, and spasticity. In all patients, nabilone was prescribed as an adjunctive treatment. Seven patients (25%) reported a slight improvement in pain symptoms. Side effects were reported by 21.4% of patients. The most common reported side effects were sedation and cognitive slowing.
Adjunctive treatment with nabilone may improve pain symptoms in a subset of pediatric chronic pain patients. Further research investigating the long-term safety and efficacy of nabilone in the treatment of chronic pain in children is needed.
儿童和青少年慢性疼痛的患病率很高。在一些患者中，疼痛可能很严重且对传统治疗方法无效。人们越来越关注将大麻素用于儿童和青少年的治疗目的。纳布啡，一种合成大麻素，在加拿大被批准用于治疗与化疗相关的恶心和呕吐。它也可用于治疗慢性疼痛的非标签用药。
本研究旨在描述纳布啡在儿科人群中用于治疗严重慢性疼痛的情况。
这是一项回顾性队列研究，研究对象为2013年7月1日至2017年6月30日期间在一家三级多学科儿科慢性疼痛诊所因慢性疼痛而开具纳布啡处方的18岁及以下患者。
在4年的研究期间，我们筛查了507例患者的病历，共确定了28例（5.5%）接受纳布啡治疗作为其慢性疼痛治疗一部分的患者。纳布啡治疗的常见适应症包括混合性神经病理性/伤害性疼痛、腹痛、神经病理性疼痛和痉挛。在所有患者中，纳布啡均作为辅助治疗药物开具。7例患者（25%）报告疼痛症状略有改善。21.4%的患者报告了副作用。最常见的副作用是镇静和认知迟缓。
纳布啡辅助治疗可能会改善一部分儿科慢性疼痛患者的疼痛症状。需要进一步研究纳布啡治疗儿童慢性疼痛的长期安全性和有效性。
