Yang Andrew, Townsend Clay B, Ilyas Asif M
Rothman Institute at Thomas Jefferson University, Philadelphia, PA.
Rothman Institute at Thomas Jefferson University, Philadelphia, PA; Rothman Orthopaedic Institute Foundation for Opioid Research & Education, Philadelphia, PA.
J Hand Surg Am. 2023 Mar;48(3):292-300. doi: 10.1016/j.jhsa.2022.11.008. Epub 2023 Jan 4.
Acute and chronic pain management remains an ongoing challenge for hand surgeons. This has been compounded by the ongoing opioid epidemic in the United States. With the increasing legalization of medical and recreational cannabis throughout the United States and other countries, previous societal stigmas about this substance keep evolving, and recognition of medical cannabis as an opioid-sparing pain management alternative is growing. A review of the current literature demonstrates a strong interest from patients regarding the use of medical cannabis for pain control. Current evidence demonstrates its efficacy and safety for chronic musculoskeletal and neuropathic pain. However, definitive conclusions regarding the efficacy of cannabis for pain control in hand and upper extremity conditions require continued investigation. The purpose of this article is to provide a general review of the mechanism of medical cannabis and a scoping review of the current evidence for its efficacy, safety, and potential applicability in hand and upper extremity conditions.
急慢性疼痛管理对手外科医生来说仍然是一个持续存在的挑战。美国持续的阿片类药物流行使这一情况更加复杂。随着医用和娱乐用大麻在美国及其他国家越来越合法化,以往对这种物质的社会污名不断演变,医用大麻作为一种阿片类药物替代的疼痛管理方法,其认可度正在提高。对当前文献的综述表明,患者对使用医用大麻控制疼痛有着浓厚兴趣。目前的证据表明其对慢性肌肉骨骼和神经性疼痛有效且安全。然而,关于大麻在手部和上肢疾病疼痛控制方面的疗效,还需要持续研究才能得出明确结论。本文旨在对医用大麻的作用机制进行一般性综述,并对其在手部和上肢疾病中的疗效、安全性及潜在适用性的现有证据进行范围综述。