Introduction
Cannabinoids, and more precisely cannabidiol (CBD), has been used growingly as an analgesic agent.
Despite a sudden increase in the amount of CBD-related articles, there are only few reports about its
safety and efficacy in the management of perioperative pain. To overcome this, we propose to
review articles questioning the use of CBD in the perioperative pain, and its effect on opioids
consumption.
Methods
We used the PubMed database to find relevant articles on the use of CBD as an analgesic therapy
during surgery. The following terms were included in the search equation: “cannabidiol” in [Mesh] or
[tiab] and “surgery” in [tiab] or “general surgery” in [Mesh] or “surgical procedures, operational” in
[Mesh]. This search was conducted on April 14, 2023, at 09:28, and generated a total of 97 results.
Results
The six studies examined CBD exposure for durations ranging from three days to one year.
Participants' average age was consistently between 57 and 68 years, with an equal gender
distribution. CBD doses varied across studies, ranging from 20 mg/day to 400 mg/day. The VAS
(Visual Analog Scale) scores showed significant differences in the first day of the first study (-1.3 on
day 1, -0.6 on day 2, -0.7 on day 7, and -0.7 on day 14), and a significant decrease in VAS scores was
observed in the second study (difference of 3.46). Regarding side effects, all six studies reported
good tolerance of CBD products, and the difference in opioid consumption was observed only in the
first and fifth studies. In the first study, the differences were -4.5 on day 1, -6.4 on day 2, -8 on day 7,
and -2.3 on day 14 and in the fifth study, there were differences of 36 at week 1 and 31.7 at week 2.
Conclusion
This literature review presents mixed results regarding the effects of CBD. Three studies showed
positive analgesic effects of CBD, while the other three did not demonstrate such effects (not
significantly). Concerning the reduction in opioid intake, the results are mainly positive but
statistically non-significant. Although we wanted to perform a prospective comparative study in spine
surgery, current Swissmedic regulations does not permit to use non-registered substances (like CBD
oil) in a clinical trial.