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|Title||[(9)-tetrahydrocannabinol and the opioid receptor agonist piritramide do not act synergistically in postoperative pain.] [Article in German]|
|Author(s)||Seeling W, Kneer L, Buchele B, Gschwend JE, Maier L, Nett C, Simmet T, Steffen P, Schneider M, Rockemann M.|
|Journal, Volume, Issue||Anaesthesist 2006;55(4):391-400.|
|Major outcome(s)||Application of THC reduced the need of an opioid to treat postoperative pain but the difference to placebo was not significant|
BACKGROUND: It is concluded from animal experiments that cannabinoid receptor and mu-opioid receptor agonists act synergistically with respect to antinociception. In order to demonstrate this effect under clinical conditions, we conducted a randomized double blind trial with patients after radical prostatectomy.PATIENTS AND METHODS: From the evening before the operation until the morning of the second postoperative day, all patients received eight oral doses of either placebo or 5 mg (9)-tetrahydrocannabinol (dronabinol). Postoperatively patients had access to patient-controlled analgesia with the mu-opioid agonist piritramide for 48 h. We expected patients receiving dronabinol to require significantly less piritramide compared to patients on placebo.RESULTS: The consumption of piritramide was recorded in 100 patients after radical retropubic prostatectomy with regional lymphadenectomy. Patients in the placebo group consumed 74 mg (median), interquartile range (IQR) 44-90 mg, patients in the verum group consumed 54 mg (median) IQR 46-88 mg. The difference between groups was not statistically significant. Plasma concentrations of (9)-THC were measurable in all patients in the verum group. The levels (median) were 1.5 ng/ml (IQR 0.6-2.3), 1.3 ng/ml (IQR 0.5-2.2) and 1.9 ng/ml (IQR 0.8-2.7) on the day of operation, the first and second postoperative day, respectively.CONCLUSION: We found neither a synergistic nor even an additive antinociceptive interaction between (9)-tetrahydrocannabinol and the mu-opioid agonist piritramide in a setting of acute postoperative pain.
|Dose(s)||3 x 5 mg|
|Participants||100 patients undergoing surgery|
|Type of publication||Medical journal|
|Address of author(s)||Klinik fur Anasthesiologie, Klinik fur Urologie und Kinderurologie, Institut fur Pharmakologie, Toxikologie und Naturheilkunde, Klinikumsapotheke, Universitat und Universitatsklinikum, Ulm.|