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Cited by 42Cannabis and Cannabinoid ResearchAnesthesia and Pain ManagementPain Management and Opioid Use

Keine synergistische Wirkung der Kombination von ∆9-Tetrahydrocannabinol und Piritramid bei postoperativen Schmerzen

Seeling, W., Kneer, L., Büchele, B., Gschwend, J. E., Maier, L., Nett, C., Simmet, T., Steffen, P. +2 more·2006·Der Anaesthesist
DOI 10.1007/s00101-005-0963-6
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Abstract

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 Delta(9)-tetrahydrocannabinol (dronabinol). Postoperatively patients had access to patient-controlled analgesia with the micro-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 Delta(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 Delta(9)-tetrahydrocannabinol and the micro-opioid agonist piritramide in a setting of acute postoperative pain.

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  • Two controlled studies found no effect of cannabinoids on opioid dose requirements.

    “Two controlled studies found no effect of cannabinoids on opioid dose requirements (Johnson et al, 2010;Seeling et al, 2006).”

    From Opioid-Sparing Effect of Cannabinoids: A Systematic Review and Meta-Analysis (2017) · cites this paper as Seeling et al, 2006

  • In Seeling 2006, median dose of piritramide alone was 74 mg (IQR 44-90) compared with 54 mg (IQR 46-88) when administered with dronabinol; the difference between intervention and control group was not significant; no evidence was found of synergistic antinociceptive interaction between delta-9-THC and piritramide for acute postoperative pain.

    “Median dose of piritramide alone was 74 mg (IQR 44-90) compared with 54 mg (IQR 46-88) when administered with dronabinol.”

    From Opioid-Sparing Effect of Cannabinoids: A Systematic Review and Meta-Analysis (2017) · cites this paper as Seeling 2006

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Authors
Seeling, W., Kneer, L., Büchele, B., Gschwend, J. E., Maier, L., Nett, C., Simmet, T., Steffen, P., Schneider, M., & Rockemann, M.
Affiliations
Universität Ulm (DE)
Corresponding author
Seeling, W.
ORCID
Simmet, T.
Venue
Der Anaesthesist
Publisher
Springer Science and Business Media LLC
Published
2006-04
Volume
55
Issue
4
Pages
391-400
ISSN
  • 0003-2417 (ISSN-L)
  • 1432-055X
DOI
10.1007/s00101-005-0963-6
OpenAlex
W364704229
Cited by
42
References
36
Citations by year
2025: 2 · 2024: 2 · 2023: 2 · 2022: 4 · 2021: 4 · 2020: 6 · 2019: 4 · 2018: 3 · 2017: 3 · 2016: 2 · 2015: 1 · 2012: 4
FWCI
0.84
Type
journal article
Language
de
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • Der Anaesthesist (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pharmacology › Cannabis and Cannabinoid Research
  • Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Keywords
delta-9-tetrahydrocannabinol, dronabinol, piritramide, postoperative pain, synergistic analgesia, opioid-cannabinoid interaction, mu-opioid receptor agonists, radical prostatectomy, patient-controlled analgesia, antinociception
MeSH terms
Aged, Analgesics, Opioid, Arousal, Body Temperature, Double-Blind Method, Drug Interactions, Hemodynamics, Humans, Lymph Node Excision, Male, Pain Measurement, Postoperative Pain, Pirinitramide, Prostatectomy, Prostatic Neoplasms, Dronabinol, Respiratory Mechanics, Analgesia, Patient-Controlled, Receptors, Opioid, mu

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