ROLE OF IMMUNE CELLS IN POSTOPERATIVE PAIN IN THE MOUSE

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More than half of the patients who undergo surgery experience pain despite analgesic treatment. Therefore, new strategies for the treatment of postoperative pain are needed. Since laparotomy is common in abdominal surgeries, studying laparotomy-induced pain in mice could provide valuable insights. We used female CD-1 mice. Laparotomy consisted of a 1.5 cm horizontal incision to gain access to the abdominal cavity. We studied three aspects of postoperative pain: movement-induced pain using infrared actimetry; pain at rest, analysing the facial expres- sions of the mice using artificial intelligence, and sensory hypersen- sitivity using the vonFrey test. We also studied the recruitment of immune cells to the surgical wound using fluorescence activated cell sorting (FACS).

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Tetrahydrocannabinol and Cannabidiol for Pain Treatment—An Update on the Evidence

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In light of the current International Association for the Study of Pain (IASP) clinical practice guidelines (CPGs) and the European Society for Medical Oncology (ESMO) guidelines, the topic of cannabinoids in relation to pain remains controversial, with insufficient research presently available. Cannabinoids are an attractive pain management option due to their synergistic effects when administered with opioids, thereby also limiting the extent of respiratory depression. On their own, however, cannabinoids have been shown to have the potential to relieve specific subtypes of chronic pain in adults, although controversies remain. Among these subtypes are neuropathic, musculoskeletal, cancer, and geriatric pain. Another interesting feature is their effectiveness in chemotherapy-induced peripheral neuropathy (CIPN). Analgesic benefits are hypothesized to extend to HIV-associated neuropathic pain, as well as to lower back pain in the elderly. The aim of this article is to provide an up-to-date review of the existing preclinical as well as clinical studies, along with relevant systematic reviews addressing the roles of various types of cannabinoids in neuropathic pain settings.

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Cannabis for chronic pain: cardiovascular safety in a nationwide Danish study

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A rising number of countries allow physicians to treat chronic pain with medical cannabis. However, recreational cannabis use has been linked with cardiovascular side effects, necessitating investigations concerning the safety of prescribed medical cannabis. Using nationwide Danish registers, patients with chronic pain initiating first-time treatment with medical cannabis during 2018–21 were identified and matched 1:5 to corresponding control patients on age, sex, chronic pain diagnosis, and concomitant use of other pain medication. The absolute risks of first-time arrhythmia (atrial fibrillation/flutter, conduction disorders, paroxysmal tachycardias, and ventricular arrhythmias) and acute coronary syndrome were reported comparing medical cannabis use with no use.

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Cannabis for medical use versus opioids for chronic non-cancer pain: a systematic review and network meta-analysis of randomised clinical trials

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The objective of this study is to evaluate the comparative benefits and harms of opioids and cannabis for medical use for chronic non-cancer pain.Randomised trials comparing any type of cannabis for medical use or opioids, against each other or placebo, with patient follow-up ≥4 weeks.

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Research progress in the management of vascular disease with cannabidiol: a review

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The morbidity and mortality rates associated with vascular disease (VD) have been gradually increasing. Currently, the most common treatment for VD is surgery, with the progress in drug therapy remaining slow. Cannabidiol (CBD) is a natural extract of Cannabis sativa L. with sedative, analgesic, and nonaddictive properties. CBD binds to 56 cardiovascular-related receptors and exerts extensive regulatory effects on the cardiovascular system, making it a potential pharmacological agent for the management of VD. However, most CBD studies have focused on neurological and cardiac diseases, and research on the management of VD with CBD is still rare. In this review, we summarize the currently available data on CBD in the management of VD, addressing four aspects: the major molecular targets of CBD in VD management, pharmacokinetic properties, therapeutic effects of CBD on common VDs, and side effects. The findings indicate that CBD has anti-anxiety, anti-oxidation, and anti-inflammatory properties and can inhibit abnormal proliferation and apoptosis of vascular smooth muscle and endothelial cells; these effects suggest CBD as a therapeutic agent for atherosclerosis, stress-induced hypertension, diabetes-related vasculopathy, ischemia-reperfusion injury, and vascular damage caused by smoking and alcohol abuse. This study provides a theoretical basis for further research on CBD in the management of VD.

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Individuals’ Values and Preferences Regarding Medical Cannabis for Chronic Pain: A Descriptive Qualitative Study

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In Canada, cannabis for medical reasons has been legal since 2001. It has been used as one of the many strategies for chronic or ongoing pain, but doctors are not given consistent information regarding its use, and existing guidance does not include the patient point of view. We did this study to explore how people living with chronic pain feel about the use of medical cannabis. We asked 52 people living with chronic pain, including current medical cannabis users, previous users, and non-users. We found that many people who used cannabis for their pain had to experiment to determine what cannabis products, routes, and doses worked for them. Benefits of medical cannabis included relief from pain, better sleep, and improved mental health. Reasons for stopping medical cannabis included no to little improvement in pain and/or sleep or the presence of unwanted side effects. Cannabidiol (CBD) products resulted in fewer unwanted effects (eg, physical or mental impairment) compared to tetrahydrocannabinol (THC) products. People discussed different routes of cannabis use including oral routes that provided longer-lasting pain relief but with a slower onset and inhaled routes with a faster onset of relief but with shorter-lived effects. People’s decisions regarding medical cannabis use for chronic pain were varied, suggesting these decisions are likely to be sensitive to individual’s values and preferences. More research is needed to learn what doses, products, and routes work for specific chronic pain conditions.

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A preliminary study evaluating self-reported effects of cannabis and cannabinoids on neuropathic pain and pain medication use in people with spinal cord injury

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Approximately 60% of individuals with a spinal cord injury (SCI) experience neuropathic pain, which often persists despite the use of various pharmacological treatments. Increasingly, the potential analgesic effects of cannabis and cannabinoid products have been studied; however, little research has been conducted among those with SCI-related neuropathic pain. Therefore, the primary objective of the study was to investigate the perceived effects of cannabis and cannabinoid use on neuropathic pain among those who were currently or had previously used these approaches. Additionally, the study aimed to determine if common pain medications are being substituted by cannabis and cannabinoids.

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Medical Marijuana for Pain Management in Hospice Care as a Complementary Approach to Scheduled Opioids: A Single Arm Study

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Opioid therapy is critical for pain relief for most hospice patients but may be limited by adverse side effects. Combining medical cannabis with opioids may help mitigate adverse effects while maintaining effective pain relief. This single-arm study investigated the impact of combined medical cannabis/opioid therapy on pain relief, opioid dose, appetite, respiratory function, well-being, nausea, and adverse events in hospice inpatients.

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The Basic Science of Cannabinoids

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The cannabis plant has been used for centuries to manage the symptoms of various ailments including pain. Hundreds of chemical compounds have been identified and isolated from the plant and elicit a variety of physiological responses by binding to specific receptors and interacting with numerous other proteins. In addition, the body makes its own cannabinoid-like compounds that are integrally involved in modulating normal and pathophysiological processes. As the legal cannabis landscape continues to evolve within the United States and throughout the world, it is important to understand the rich science behind the effects of the plant and the implications for providers and patients. This narrative review aims to provide an overview of the basic science of the cannabinoids by describing the discovery and function of the endocannabinoid system, pharmacology of cannabinoids, and areas for future research and therapeutic development as they relate to perioperative and chronic pain medicine.

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Efficacy and usability of a cannabidiol-infused tampon for the relief of primary dysmenorrhea

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This study aimed to assess efficacy and usability of Cannabidiol (CBD) infused tampons for the relief of primary dysmenorrhea, a condition affecting 50–95% assigned female at birth. While primary dysmenorrhea affects a significant percentage of females, there remains a notable absence of specialized medications or devices to alleviate the intense pain that hinders daily activities. We have developed a CBD-infused tampon, lubricated for comfort and ease, recognising the potential benefits of cannabinoids in pain management.

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Medical Cannabis: A Review from the American Society of Pain and Neuroscience

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Cannabinoids have recently gained a renewed interest due to their potential applicability to various medical conditions, specifically the management of chronic pain conditions. Unlike many other medications, medical cannabis is not associated with serious adverse events, and no overdose deaths have been reported. However, both safety and efficacy data for medical cannabis treatment of chronic, nonmalignant pain conditions are lacking. Therefore, representatives from the American Society of Pain and Neuroscience summarize the evidence, according to level and grade, for medical cannabis treatment of several different pain conditions.

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The holistic effects of medical cannabis compared to opioids on pain experience in Finnish patients with chronic painional study

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Medical cannabis (MC) is increasingly used for chronic pain, but it is unclear how it aids in pain management. Previous literature suggests that MC could holistically alter the pain experience instead of only targeting pain intensity. However, this hypothesis has not been previously systematically tested.

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