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Cannabis consumers may experience more pain after surgery – study

The findings have led to calls for more research into the effects of cannabis on surgical outcomes.



Cannabis consumers may experience more pain after surgery - study
Photo: Marcelo Leal/Unsplash

Researchers behind a new study say people who consume cannabis may experience more postoperative pain than those who don’t.

A new study exploring the effects of cannabis on postoperative pain, suggests that adults who consumed cannabis experienced more pain after surgery than those who did not.

Researchers analysed the records of 34,521 adult patients, of which 1,681 of them were categorised as cannabis users — who had elective surgeries at Cleveland Clinic between January 2010 – December 2020. 

One group of patients had consumed cannabis within 30 days before surgery, while the other patients had never used cannabis. 

According to the researchers, patients who used cannabis experienced 14% more pain during the first 24 hours after surgery compared to the patients who never used cannabis. 

Additionally, patients who used cannabis consumed 7% more opioids after surgery, which the authors note was not statistically significant, but is likely clinically relevant. 

The findings may come as a surprise to some, given that cannabis is increasingly being used as a treatment to manage chronic pain, with many studies pointing to its ability to reduce opioid use.

However, recent papers have linked regular cannabis use to a risk of some postoperative complications and suggest consumers may require higher levels of sedation.

Elyad Ekrami, M.D., lead author of the study and clinical research fellow of the Outcomes Research Department at Cleveland Clinic’s Anesthesiology Institute, commented: “Cannabis is the most commonly used illicit drug in the United States and increasingly used as an alternative treatment for chronic pain, but there is limited data that shows how it affects patient outcomes after surgery.

“Our study shows that adults who use cannabis are having more — not less — postoperative pain. Consequently, they have higher opioid consumption after surgery.”

Dr Ekrami continued: ”The association between cannabis use, pain scores and opioid consumption has been reported before in smaller studies, but they’ve had conflicting results.

Our study has a much larger sample size and does not include patients with chronic pain diagnosis or those who received regional anaesthesia, which would have seriously conflicted our results. Furthermore, our study groups were balanced by confounding factors including age, sex, tobacco and other illicit drug use, as well as depression and psychological disorders.”

The findings, which were presented at the ANESTHESIOLOGY® 2022 annual meeting, have led to calls for more research into the effects of cannabis on surgical outcomes.

“Physicians should consider that patients using cannabis may have more pain and require slightly higher doses of opioids after surgery, emphasising the need to continue exploring a multimodal approach to post-surgical pain control,” he said.  

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Sarah Sinclair is a respected cannabis journalist writing on subjects related to science, medicine, research, health and wellness. She is managing editor of Cannabis Health, the UK’s leading title covering medical cannabis and CBD, and sister titles, Cannabis Wealth and Psychedelic Health. Sarah has an NCTJ journalism qualification and an MA in Journalism from the University of Sunderland. Sarah has over six years experience working on newspapers, magazines and digital-first titles, the last two of which have been in the cannabis sector. She has also completed training through the Medical Cannabis Clinicians Society securing a certificate in Medical Cannabis Explained. She is a member of PLEA’s (Patient-Led Engagement for Access) advisory board, has hosted several webinars on cannabis and women's health and has moderated at industry events such as Cannabis Europa. Sarah Sinclair is the editor of Cannabis Health. Got a story? Email / Follow us on Twitter: @CannabisHNews / Instagram: @cannabishealthmag


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