Abstract
Objective
To determine whether cannabis users have different pain scores after gynaecologic
oncology surgery than non-cannabis users.
Methods
A retrospective chart review was completed for 654 patients who underwent gynaecologic
oncology surgery during a 2-year period. The primary outcome was postoperative pain
at 12 and 36 hours after surgery using an 11-point pain scale. Secondary outcomes
included opioid consumption, length of hospital stay, opioid side effects, and sleep
disturbance.
Results
Of all patients included in this study, 64 used cannabis and 590 did not. Propensity
score matching and list-wise deletion identified 57 matched pairs. Pain scores were
significantly higher at 12 hours (P < 0.001) and 36 hours (P =0.002) after surgery in cannabis users (median pain scores 6 [IQR 5–7]) and 5 [IQR
4–7], respectively) than non-users (median pain scores 4 [IQR 3–6] and 4 ([IQR 2–5],
respectively). Median opioid consumption was significantly higher at 12 hours (P = 0.039) and 36 hours (P = 0.044) after surgery in cannabis users (oral morphine equivalent [OME] 20 [IQR
10–40] mg and OME 40 [IQR 10–100] mg, respectively) than non-users (OME 10 [IQR 5–20]
mg and OME 30 mg [IQR 7.5–50] mg, respectively]. Sleep disturbance was significantly
higher in cannabis users (odds ratio 3.31; P = 0.009).
Conclusions
After gynaecologic oncology surgery, patients who used cannabis preoperatively had
higher postoperative pain scores, higher opioid use, and more sleep disturbance than
non-users. This suggests that preoperative cannabis use is a risk factor for postoperative
pain.
Résumé
Objectif
Déterminer si les consommatrices de cannabis ont des scores de douleur après une intervention
chirurgicale gynéco-oncologique différents de ceux des non-consommatrices.
Méthodologie
Un examen rétrospectif a été effectué sur les dossiers de 654 patientes ayant subi
une intervention chirurgicale gynéco-oncologique au cours d’une période de 2 ans.
Le critère de jugement principal était la douleur postopératoire à 12 et 36 heures
post-intervention mesurée sur une échelle de douleur de 11 points. Les critères de
jugement secondaires étaient la consommation d’opioïdes, la durée du séjour à l’hôpital,
les effets indésirables des opioïdes et les troubles du sommeil.
Résultats
Cette étude inclut 64 consommatrices et 590 non-consommatrices de cannabis. La correspondance
des scores de propension et la suppression des dossiers incomplets ont permis de former
57 paires appariées. Les scores de douleur étaient significativement plus élevés à
12 heures (p < 0,001) et à 36 heures (p = 0,002) post-intervention chez les consommatrices (scores de douleur médians respectifs
: 6 [IIQ : 5-7]) et 5 [IIQ : 4-7]) que chez les non-consommatrices (scores de douleur
médians respectifs : 4 [IIQ : 3-6] et 4 [IIQ : 2-5]). La consommation médiane d’opioïdes
était significativement plus élevée à 12 heures (p = 0,039) et à 36 heures (p = 0,044) post-intervention chez les consommatrices (20 mg [IIQ : 10-40] en équivalent
de morphine orale [EMO] et 40 mg [IIQ : 10-100] en EMO, respectivement) que chez les
non-consommatrices (10 mg [IIQ : 5-20] en EMO et 30 mg [IIQ : 7,5-50] en EMO, respectivement).
Les troubles du sommeil étaient significativement plus élevés chez les consommatrices
de cannabis (rapport de cotes : 3,31; p = 0,009).
Conclusions
Après une intervention chirurgicale gynéco-oncologique, les patientes ayant consommé
du cannabis avant l’intervention avaient un score de douleur postopératoire plus élevé,
une consommation plus élevée d’opioïdes et plus de troubles du sommeil comparativement
aux non-consommatrices. Ces observations indiquent que la consommation préopératoire
de cannabis est un facteur de risque de la douleur postopératoire.
Keywords
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Article info
Publication history
Published online: February 21, 2022
Accepted:
January 26,
2022
Received:
December 11,
2021
Footnotes
Disclosures: The authors declare they have nothing to disclose.
All authors have indicated they meet the journal’s requirements for authorship.
Identification
Copyright
© 2022 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
