周到地将大麻产品整合到慢性疼痛治疗中
Kevin F Boehnke1, Christopher L Wu2,3, Daniel J Clauw1
1From the Anesthesiology Department, Chronic Pain and Fatigue Research Center, University of Michigan Medical School, Ann Arbor, Michigan.
Anesthesia and analgesia
|December 15, 2023
概括
大麻产品 (CP) 和基于大麻的药物 (CBM) 提供潜在的疼痛缓解,但缺乏强有力的临床证据. 临床医生应通过减少危害和以患者为中心的护理原则指导使用这些产品的患者.
科学领域:
- 药理学 药理学是指药理学的学科.
- 疼痛管理 疼痛管理
- 大麻治疗药物 大麻治疗药物
背景情况:
- 大麻产品 (CP) 和基于大麻的药物 (CBM) 越来越多地用于治疗疼痛.
- 社会接受和法律变化促进了患者获得有限的临床监督的CP.
- 有限的临床试验数据存在CBMs在疼痛管理,而观察性研究显示广泛使用CP疼痛,经常取代其他药物.
研究的目的:
- 为临床医生提供实用指导,以教育和与使用CBM治疗疼痛的患者合作.
- 综合现有关于CBM和CP疼痛管理的证据.
- 为临床医生提供一个框架,在治疗不确定性中引导患者使用CP.
主要方法:
- 关于CP和CBM治疗疼痛的现有文献的叙事综合.
- 分析临床试验数据和观察数据之间的差异.
- 基于证据审查的临床指导原则的制定.
主要成果:
- 对CBM在疼痛管理中的临床试验文献是有限的和不确定的.
- 现有的试验产品和剂量不适用于当前的大麻市场.
- 观察数据表明,患者广泛使用CP来缓解疼痛.
结论:
- 临床医生需要务实的指导来支持使用CBM治疗疼痛的患者.
- 指导应侧重于维持治疗联盟,降低危害,最大化效益和以患者为中心的护理.
- 采用这些原则可以优化临床机会和CP在疼痛管理的潜在好处,尽管证据差距.
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