A study of levonantradol, a cannabinol derivative, for analgesia in post operative pain

Kantor, Thomas G.; Hopper, Mary E.

doi:10.1016/0304-3959(81)90248-7

Cited by 6 publications

(11 citation statements)

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“…The presentation follows the suggested format provided in the QUORUM statement 9. Of the 11 excluded trials, three did not use randomised treatment comparisons,10-12 four did not use subjective pain outcomes,13-16 two had studied experimentally induced pain, 17 18 and one was published as a letter19 and one as an abstract 20…”

Section: Resultsmentioning

confidence: 99%

Are cannabinoids an effective and safe treatment option in the management of pain? A qualitative systematic review

Campbell

2001

BMJ

356

199

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Objective To establish whether cannabis is an effective and safe treatment option in the management of pain. Design Systematic review of randomised controlled trials. Data sources Electronic databases Medline, Embase, Oxford Pain Database, and Cochrane Library; references from identified papers; hand searches. Study selection Trials of cannabis given by any route of administration (experimental intervention) with any analgesic or placebo (control intervention) in patients with acute, chronic non-malignant, or cancer pain. Outcomes examined were pain intensity scores, pain relief scores, and adverse effects. Validity of trials was assessed independently with the Oxford score. Data extraction Independent data extraction; discrepancies resolved by consensus. Data synthesis 20 randomised controlled trials were identified, 11 of which were excluded. Of the 9 included trials (222 patients), 5 trials related to cancer pain, 2 to chronic non-malignant pain, and 2 to acute postoperative pain. No randomised controlled trials evaluated cannabis; all tested active substances were cannabinoids. Oral delta-9-tetrahydrocannabinol (THC) 5-20 mg, an oral synthetic nitrogen analogue of THC 1 mg, and intramuscular levonantradol 1.5-3 mg were about as effective as codeine 50-120 mg, and oral benzopyranoperidine 2-4 mg was less effective than codeine 60-120 mg and no better than placebo. Adverse effects, most often psychotropic, were common.

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Section: Resultsmentioning

confidence: 99%

Are cannabinoids an effective and safe treatment option in the management of pain? A qualitative systematic review

Campbell

2001

BMJ

356

199

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“…Of the 33 included studies, 5 were RCTs, 13,24,34,35,50 1 was a nonrandomized intervention study, 29 8 were case reports/ case series, 30,31,[36][37][38][39]51,52 6 were surveys, [25][26][27][28]53,54 1 was a qualitative study 54 and 12 were systematic reviews. 32,33,40,[41][42][43][44][45][46][47][48][49] Of the 12 systematic reviews, 9 included RCTs, 32,[41][42][43][44][45][46][47]49 2 included nonrandomized studies 33,40 and 1 review 48 was unclear on the design of the included studies.…”

Section: Methodsmentioning

confidence: 99%

Section: Populationmentioning

confidence: 99%

“…The 6 controlled intervention studies 13,24,29,34,35,50 (5 RCTs and 1 nonrandomized intervention study) included a total of 681 patients. Of these patients, 171 (25.1%) underwent directly orthopedic-related procedures, although in 1 study 50 it was unclear what type of surgery 81 patients underwent. Four of the 6 studies evaluated cannabis use for acute postsurgical pain, 24,29,34,50 1 evaluated patients with rheumatoid arthritis 13 and 1 evaluated chronic neuropathic pain, 35 including 25 orthopedic patients ( Table 5).…”

Section: Populationmentioning

confidence: 99%

“…Three studies evaluated the efficacy of nabilone, 24,34,35 an oral synthetic cannabinoid. One study evaluated levonantradol, 50 another synthetic cannabinoid that can be administered orally or intramuscularly. One study evaluated nabiximols 13 (trade name Sativex), which is an oral cannabis extract spray that delivers a set dosage of THC and CBD per spray.…”

Section: Efficacy -Controlled Studiesmentioning

confidence: 99%

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Cannabis for pain in orthopedics: a systematic review focusing on study methodology

Madden

George

Hoek

et al. 2019

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Background: Medical cannabis use is an emerging topic of interest in orthopedics. Although there is a large amount of literature on medical cannabis use for managing various types of pain, few studies have focused on orthopedic conditions. There is little high-quality evidence in core orthopedic areas. The objective of this study was to summarize the literature on the efficacy of cannabis use for pain related to orthopedic conditions. Methods: We conducted a systematic review of the literature on the use of cannabinoids for pain management in core orthopedic conditions. Two independent reviewers extracted information on reporting quality, risk of bias, drugs, population, control, duration of study, pain outcomes and the authors' conclusions regarding efficacy for pain outcomes. Results: We identified 33 orthopedic studies, including 21 primary studies and 12 reviews. Study quality was generally low to moderate. Six of the included studies had a control group and 15 were noncontrolled studies. Methodologies, drugs and protocols of administration varied greatly across studies. Study conclusions were generally positive in noncontrolled studies and mixed in controlled studies. Studies using higher doses tended to conclude that cannabis use was effective, but the potential for harmful effects may also be increased with higher doses. Conclusion: Variability in the methodologies used in cannabis research makes it challenging to draw conclusions about dosing, routes and frequency of administration. Most of the existing evidence suggests that medical cannabis use is effective, but this efficacy has been demonstrated only when either there is no comparator or cannabis is compared with placebo. Studies using an active comparator have not demonstrated efficacy. Future research should focus on improving study reporting and methodologic quality so that protocols that optimize pain control while minimizing harmful effects can be determined. Contexte : La consommation de cannabis à des fins médicales est un sujet d'intérêt émergent en orthopédie. Malgré l'existence d'un important corpus de littérature médicale sur l'utilisation du cannabis pour traiter divers types de douleurs, peu d'études ont porté sur les problèmes orthopédiques. On dispose de peu de données probantes de grande qualité relatives aux principaux domaines de l'orthopédie. L'objectif de cette étude était de résumer la littérature sur l'efficacité du cannabis à soulager les douleurs orthopédiques. Méthodes : Nous avons réalisé une revue systématique de la littérature sur l'utilisation des cannabinoïdes pour la prise en charge de la douleur associée aux principaux problèmes orthopédiques. Deux examinateurs indépendants ont extrait l'information sur la qualité des rapports, le risque de biais, les médicaments, les populations et groupes témoins, la durée des études, les scores de douleur et les conclusions des auteurs quant à l'efficacité au plan des scores de douleur. Résultats : Nous avons recensé 33 études orthopédiques, dont 21 études primaires et 12 revues. La ...

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Cannabinoids versus placebo for pain: A systematic review with meta-analysis and Trial Sequential Analysis

et al. 2023

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Objectives To assess the benefits and harms of cannabinoids in participants with pain. Design Systematic review of randomised clinical trials with meta-analysis, Trial Sequential Analysis, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Data sources The Cochrane Library, MEDLINE, Embase, Science Citation Index, and BIOSIS. Eligibility criteria for selecting studies Published and unpublished randomised clinical trials comparing cannabinoids versus placebo in participants with any type of pain. Main outcome measures All-cause mortality, pain, adverse events, quality of life, cannabinoid dependence, psychosis, and quality of sleep. Results We included 65 randomised placebo-controlled clinical trials enrolling 7017 participants. Fifty-nine of the trials and all outcome results were at high risk of bias. Meta-analysis and Trial Sequential Analysis showed no evidence of a difference between cannabinoids versus placebo on all-cause mortality (RR 1.20; 98% CI 0.85 to 1.67; P = 0.22). Meta-analyses and Trial Sequential Analysis showed that cannabinoids neither reduced acute pain (mean difference numerical rating scale (NRS) 0.52; 98% CI -0.40 to 1.43; P = 0.19) or cancer pain (mean difference NRS -0.13; 98% CI -0.33 to 0.06; P = 0.1) nor improved quality of life (mean difference -1.38; 98% CI -11.81 to 9.04; P = 0.33). Meta-analyses and Trial Sequential Analysis showed that cannabinoids reduced chronic pain (mean difference NRS -0.43; 98% CI -0.72 to -0.15; P = 0.0004) and improved quality of sleep (mean difference -0.42; 95% CI -0.65 to -0.20; P = 0.0003). However, both effect sizes were below our predefined minimal important differences. Meta-analysis and Trial Sequential Analysis indicated that cannabinoids increased the risk of non-serious adverse events (RR 1.20; 95% CI 1.15 to 1.25; P < 0.001) but not serious adverse events (RR 1.18; 98% CI 0.95 to 1.45; P = 0.07). None of the included trials reported on cannabinoid dependence or psychosis. Conclusions Cannabinoids reduced chronic pain and improved quality of sleep, but the effect sizes are of questionable importance. Cannabinoids had no effects on acute pain or cancer pain and increased the risks of non-serious adverse events. The harmful effects of cannabinoids for pain seem to outweigh the potential benefits.

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A study of levonantradol, a cannabinol derivative, for analgesia in post operative pain

Cited by 6 publications

References 0 publications

Are cannabinoids an effective and safe treatment option in the management of pain? A qualitative systematic review

Are cannabinoids an effective and safe treatment option in the management of pain? A qualitative systematic review

Cannabis for pain in orthopedics: a systematic review focusing on study methodology

Cannabinoids versus placebo for pain: A systematic review with meta-analysis and Trial Sequential Analysis

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