Apr 3, 2022 12:00:00 AM

Surgeons Interested in Using Cannabidiol (CBD) as a Potential Pain Management Strategy After Surgery

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Orlando, FL,
October 18,2019

A comprehensive study and analysis.

Orthopedic surgeons expressed positive attitudes overall toward the potential use of cannabidiol (CBD) for pain relief after surgery, provided that more research is conducted on the subject, according to a survey done at Hospital for Special Surgery (HSS) and presented at the 2019 Society of Anesthesia and Sleep Medicine (SASM) Annual Meeting.1
If found to be beneficial with minimal side effects, CBD could be especially useful in patients with comorbidities that put them at increased risk of harm from opioids, such as obstructive sleep apnea (OSA).
In recent years, clinicians and researchers have increasingly focused on relieving pain after surgery using multiple nonopioid pain management approaches, referred to as multimodal analgesia. The technique can lessen the amount of opioids patients take for pain relief, or even eliminate the need for opioids altogether.
“Sleep apnea is directly impacted by medications that are respiratory depressants. Any of the drugs we use during an anesthetic, including opioids, will decrease respiratory function and make it easier for patients to collapse their airway, which is really the one feature that makes up sleep apnea,” explained Stavros Memtsoudis, MD, PhD, MBA, a lead researcher on the study who is an anesthesiologist at HSS and president of the SASM. “Because of that, there is always concern about using opioids in patients with sleep apnea, that you’re going to make their symptoms worse, which can potentially lead to significant complications.”
“There’s an increasing awareness of this problem. Therefore, anesthesiologists try to avoid opioids by utilizing alternative approaches such as peripheral nerve blocks. In addition to that, we use nonopioid analgesics to achieve pain control without impacting respiration,” he said. “CBD, by virtue of its anti-inflammatory action, could potentially have some pain-relieving properties, without having the depressant effects of opioids.”
To examine surgeons’ current knowledge about CBD’s clinical uses and their interest in CBD as a potential recovery method after surgery, researchers designed an anonymous 11-item questionnaire and distributed it to surgeons at HSS.
A total of 94 clinicians, mostly joint arthroplasty orthopedists or sports medicine specialists with less than 5 years to more than 25 years in practice, completed the questionnaire. The survey results showed:

86% of surgeons were familiar with CBD, though only 4% said they were very familiar
No surgeons thought CBD harmed the recovery process; 28% thought of it as a useful adjunct to recovery; 68% said they did not know if it was useful
Of those who said they thought CBD was a useful adjunct, 64% thought it was either moderately or very useful
77% of surgeons said they would agree to the use of CBD during recovery if suggested by a patient or another provider
83% of surgeons expressed interest in learning more about CBD; 88% expressed interest in further study of CBD;
85% were open to recommending it if it is shown to be opioid and/or NSAID sparing;81% would direct a patient to use CBD as part of a multimodal analgesia recovery plan if shown to be beneficial with minimal side effects
24% of surgeons listed concerns with CBD including safety and/or a lack of clinical data

“We found that the surveyed surgeons expressed generally positive attitudes toward the use of CBD and expressed a desire for further study to address safety and efficacy of CBD in their patients,” said HSS researcher Alexandra Sideris, PhD. “CBD has never been studied before for recovery from surgery, mainly due to regulatory barriers precluding surgeons and clinicians from studying this compound within a hospital. Recent legislative changes are giving researchers and clinicians the opportunity to study CBD, and we are now taking advantage of that opportunity.”
Reference
1. Alexandra Sideris PhD, Valeria Rotundo BA, Kethy M Jules-Elysee MD, Jawad Saleh PharmD, Stavros G. Memtsoudis MD PhD MBA. “Cannabidiol as part of multimodal pain management? A survey of surgeons’ attitudes and knowledge.” Presented at 9th Annual Society of Anesthesia and Sleep Medicine Meeting (SASM), October 17-18, 2019; Orlando, FL.
About HSS
HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the 12th consecutive year), No. 4 in rheumatology by U.S. News & World Report (2021-2022), and the best pediatric orthopedic hospital in NY, NJ and CT by U.S. News & World Report “Best Children’s Hospitals” list (2021-2022). In a survey of medical professionals in more than 20 countries by Newsweek, HSS is ranked world #1 in orthopedics for a second consecutive year (2022). Founded in 1863, the Hospital has the lowest complication and readmission rates in the nation for orthopedics, and among the lowest infection rates. HSS was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center five consecutive times. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State, as well as in Florida. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. The HSS Innovation Institute works to realize the potential of new drugs, therapeutics and devices. The HSS Education Institute is a trusted leader in advancing musculoskeletal knowledge and research for physicians, nurses, allied health professionals, academic trainees, and consumers in more than 145 countries. The institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally.

Credit to www.hss.edu on this 2019 publication

The Growing Interest Among Surgeons in Using CBD for Post-Surgical Pain Management
Introduction

The medical community, for decades, has grappled with the challenge of finding pain management solutions that are both effective and devoid of addictive properties. This search has become even more pressing and significant in light of the devastating opioid crisis that has affected countless lives globally. As the world shifts towards more holistic and natural therapeutic approaches, CBD, or Cannabidiol, has risen to prominence as a promising alternative. This non-psychoactive compound derived from the cannabis plant offers potential therapeutic benefits without the high associated with THC. Among the medical professionals, orthopedic surgeons, who frequently deal with patients recovering from surgeries and in need of efficient pain relief, are particularly intrigued. Their growing curiosity is encapsulated in the phrase "Surgeons interested in using CBD." This burgeoning interest isn't just anecdotal; it's substantiated by initial research findings and the overwhelmingly positive reception of the compound's potential therapeutic advantages.

Understanding CBD and Its Potential
The Nature of Cannabidiol (CBD)
Cannabidiol, commonly referred to as CBD, is one of the many compounds derived from the cannabis plant. Unlike its counterpart, THC (Tetrahydrocannabinol), which is renowned for inducing psychoactive effects or the sensation of being "high," CBD does not have these mind-altering properties. This fundamental difference between the two compounds has led to a surge in interest in CBD, especially in the medical community, as they seek alternatives to traditional pain medications.
Therapeutic Benefits of CBD
Over the years, extensive research has been conducted to understand the potential therapeutic benefits of CBD. Preliminary studies and anecdotal evidence suggest that CBD may possess anti-inflammatory, analgesic, and anxiolytic properties. These potential benefits, combined with its non-psychoactive nature, make CBD an attractive option for those looking for relief from various ailments without the accompanying high that THC provides.
CBD in Post-Operative Pain Management
Post-operative pain management is a critical aspect of patient care, and finding effective, non-addictive solutions has always been a priority for medical professionals. With the opioid crisis highlighting the dangers of over-reliance on certain pain medications, the medical community is in dire need of safer alternatives. This is where CBD comes into play. Its potential anti-inflammatory and pain-relieving properties make it a candidate of interest for surgeons and anesthesiologists looking to enhance post-operative recovery and reduce patient discomfort.
Surgeons' Growing Interest in CBD
The appeal of CBD extends significantly within the surgical community. Surgeons, always on the lookout for innovative and effective pain management strategies, are increasingly considering CBD as a potential adjunct in post-operative care. Its promise of pain relief without the risk of addiction or psychoactive effects positions CBD as a potential game-changer in post-surgical recovery. As research continues and more clinical trials are conducted, the role of CBD in post-operative care is expected to become more defined, offering hope to both medical professionals and patients alike..
Orthopedic Surgeons and Their Positive Attitude
the Hospital for Special Surgery (HSS) conducted a survey that was presented at the 2019 Society of Anesthesia and Sleep Medicine (SASM) Annual Meeting. This survey aimed to gauge the attitudes of orthopedic surgeons towards the use of cannabidiol (CBD) for post-operative pain management. The results of this survey are significant as orthopedic surgeons are often at the forefront of managing post-operative pain, and their opinions can influence the broader medical community's stance on alternative pain management solutions.
The increasing interest in CBD as a potential pain management solution is rooted in its non-psychoactive properties, distinguishing it from THC, another compound found in the cannabis plant known for its mind-altering effects. The distinction between CBD and THC is crucial, especially when considering the potential side effects and the patient's overall well-being post-surgery. The opioid crisis has further underscored the need for effective, non-addictive pain management solutions, making the exploration of CBD's potential benefits even more pertinent1.
Orthopedic surgeons, given their frequent interactions with patients experiencing post-operative pain, are in a unique position to provide insights into the effectiveness of alternative pain management solutions. Their positive attitude towards CBD, as revealed in the HSS survey, suggests a growing acceptance and curiosity about this compound's potential benefits. However, it's essential to note that while the preliminary findings are promising, comprehensive clinical trials and studies are needed to establish CBD's efficacy conclusively.
The survey's results also highlight the medical community's evolving stance on natural alternatives for pain management. With the adverse effects of prolonged opioid use becoming increasingly evident, there's a pressing need for safer, effective alternatives. CBD, with its suggested therapeutic benefits without the high associated with THC, presents a potential solution that many surgeons are keen to explore further.
In conclusion, the survey conducted at HSS and presented at the 2019 SASM Annual Meeting offers valuable insights into the medical community's views on CBD as a potential post-operative pain management solution. The positive attitudes of orthopedic surgeons towards CBD underscore the compound's potential and the broader shift towards exploring natural alternatives in the realm of pain management.
Footnotes

SASM 2019 Annual Meeting ↩

CBD and Appetite Suppression
Cannabidiol (CBD) has been gaining attention in the medical community for its potential therapeutic benefits, one of which is its suggested ability to suppress appetite. This property of CBD stands in stark contrast to another well-known compound in the cannabis plant, THC (tetrahydrocannabinol). THC is often associated with stimulating appetite, leading to the colloquially known "munchies" effect, where individuals experience an increased desire to consume food1. This appetite-stimulating effect of THC has been documented in various studies and is a well-recognized phenomenon among cannabis users.
For surgeons, especially those dealing with post-operative care, the appetite-suppressing effects of CBD could offer a unique advantage. Post-operative weight gain is a concern for many patients, as certain surgeries, especially those related to orthopedics or bariatric procedures, may limit mobility during the recovery phase. Limited mobility can lead to reduced calorie expenditure, and when combined with increased calorie intake, can result in weight gain2. Therefore, an agent that can potentially suppress appetite, like CBD, could be invaluable in managing this post-operative challenge.
Furthermore, weight management post-surgery is not just about aesthetics. Excessive weight gain can put additional strain on healing tissues, potentially prolonging recovery or leading to complications. For instance, in orthopedic surgeries involving the joints, weight gain can exert extra pressure on the healing joint, potentially affecting the surgical outcome3. Thus, surgeons interested in using CBD might see it as a dual-benefit compound – aiding in pain management and potentially assisting in post-operative weight management.
In conclusion, while the appetite-suppressing effects of CBD need further research and validation, preliminary findings suggest it could be a valuable tool in the surgeon's arsenal. As the medical community continues to explore the multifaceted benefits of CBD, its role in post-operative care, especially concerning weight management, is likely to gain more attention.
Footnotes

Metabolic Benefits and Implications for Post-Surgical Recovery
CBD's Role in Metabolic Health
Cannabidiol (CBD), a non-psychoactive compound derived from the cannabis plant, has been the subject of extensive research due to its myriad potential therapeutic benefits. One area that has garnered significant attention is CBD's role in metabolic health. A study from 2013 highlighted CBD's potential in managing glucose intolerance related to obesity1. Glucose intolerance is a precursor to more severe metabolic disorders like diabetes, and managing it is crucial for overall health. The study suggests that CBD might play a pivotal role in this aspect, offering hope to countless individuals battling metabolic disorders.
Contrasting Effects of CBD and THC on Appetite
While THC, another compound found in the cannabis plant, is often associated with stimulating appetite, leading to the well-known "munchies," CBD appears to have the opposite effect. A study highlighted by Leafly suggests that CBD might support weight loss and metabolism2. This appetite-suppressing effect of CBD contrasts sharply with THC's appetite-enhancing properties. For surgeons interested in using CBD, this distinction is of paramount importance, especially when considering post-operative weight management for patients.
CBD's Potential in Obesity Management
Obesity is a global health concern, with numerous associated risks ranging from cardiovascular diseases to mental health issues. The search for effective, natural solutions to combat obesity is ongoing. Research published in PubMed suggests that phytocannabinoids derived from Cannabis sativa, including CBD, have therapeutic potential due to their anti-inflammatory, antioxidant, and neuroprotective properties3. These properties make CBD a promising candidate for reducing and reversing inflammation and comorbidities associated with obesity.
Surgeons' Perspective on CBD
Given the potential benefits of CBD in metabolic health and weight management, it's no surprise that medical professionals, including surgeons, are taking note. Surgeons interested in using CBD are likely drawn to its dual benefits – not only can it potentially alleviate post-operative pain, but it might also support metabolic health, making recovery smoother and more holistic for patients. As more research emerges, it's anticipated that the medical community's interest in CBD, especially for its metabolic benefits, will only grow.

References:

The Significance of Rodent Studies
The Value of Rodent Studies in Medical Research
Rodent studies have long been a cornerstone in biomedical research. Their genetic, biological, and behavioral similarities to humans make them invaluable models for understanding human physiology and disease. While human trials remain the definitive standard for medical research, rodent studies offer a controlled environment where variables can be manipulated to observe outcomes, providing crucial preliminary insights. This is especially true in the realm of drug testing and understanding pharmacological effects, where rodent models often serve as the first step before human clinical trials.
CBD's Influence on Rodent Appetite and Metabolism
Cannabidiol (CBD) has been the subject of numerous studies aiming to decipher its myriad potential therapeutic effects. In rodent models, research has indicated that CBD can have a significant impact on appetite, satiety, and energy metabolism1. For instance, a study published in the European Journal of Pharmacology found that CBD influenced food intake and body weight in rats, suggesting an interaction with the brain regions responsible for hunger, satiety, and energy balance2. Such findings provide foundational knowledge, hinting at the potential mechanisms through which CBD might exert its effects in humans.
Implications for Post-operative Care
For surgeons, managing post-operative care is a delicate balance. Ensuring pain relief, promoting healing, and minimizing side effects are all paramount. The findings from rodent studies suggesting CBD's influence on appetite and metabolism can be particularly intriguing in this context. If CBD can modulate appetite and energy balance, it might serve as a valuable tool in post-operative care, especially for patients at risk of weight-related complications or those who need to maintain a specific dietary regimen after surgery.
Surgeons and the Potential of CBD
Given the promising results from rodent studies, it's understandable why surgeons interested in using CBD might consider its potential benefits for post-operative care. While more extensive human trials are needed to confirm these effects, the preliminary data offers hope. As the medical community continues to explore CBD's potential, its role in post-operative care, especially concerning appetite and metabolic health, could become more defined, offering surgeons an additional tool in their arsenal for patient care.

Safety First: The Lack of Psychoactive Effects
The Distinctive Nature of CBD in Pain Management
Cannabidiol (CBD) has rapidly gained attention in the medical community, particularly among surgeons interested in using CBD for post-operative care. One of the primary reasons for this growing interest is CBD's non-psychoactive nature. Unlike THC, the compound in cannabis responsible for the characteristic "high," CBD does not induce these mind-altering effects. This distinction is of paramount importance in a clinical setting. When patients are in recovery, the primary goal is to ensure they experience relief from pain and discomfort without introducing additional cognitive challenges or side effects1.
Ensuring Patient Safety and Comfort
Post-operative care is a delicate phase where the patient's comfort, safety, and swift recovery are the primary concerns for any surgeon. Traditional pain management drugs, especially opioids, can introduce a range of side effects, from drowsiness and constipation to the risk of dependency and overdose. CBD's ability to potentially provide relief without the psychoactive effects means that patients can remain alert and oriented, facilitating a smoother and more comfortable recovery process2.
The Shift Towards Non-Psychoactive Pain Management
The medical landscape is evolving, with an increasing emphasis on patient-centered care. Surgeons interested in using CBD are at the forefront of this shift, recognizing the compound's potential in offering effective pain relief without the cognitive impairment associated with other medications. This patient-first approach ensures that individuals can benefit from the therapeutic properties of CBD without the fear of experiencing a "high" or other unwanted side effects.
Redefining Pain Management in Surgical Care
The potential of CBD in redefining pain management cannot be understated. As the medical community grapples with the challenges posed by the opioid epidemic, the search for safer, non-addictive pain management solutions has become more urgent than ever. CBD, with its promising therapeutic profile and lack of pronounced psychoactive effects, emerges as a beacon of hope in this quest. For surgeons and their patients, this could herald a new era of post-operative care, where pain management is both effective and safe3.

Human Clinical Trials: The Next Frontier

The Groundbreaking ECS Brands Clinical Study
In the ever-evolving landscape of medical research, the ECS Brands' 90-day clinical study stands out as a pivotal piece of research that has the potential to reshape our understanding of pain management. Conducted with rigorous scientific standards, this study delved into the therapeutic properties of CBD, particularly its efficacy in managing pain1. The results from such studies are not just numbers or data points; they represent hope for countless patients seeking relief from post-operative pain and for surgeons in search of safer, more effective pain management solutions.
Empirical Evidence: The Cornerstone of Medical Advancements
For any medical intervention to gain widespread acceptance, empirical evidence is paramount. The ECS Brands' study provides just that for surgeons interested in using CBD. In a world where anecdotal claims are plentiful, rigorous clinical studies like this one offer concrete, verifiable evidence that can be relied upon. Such studies form the bedrock upon which medical protocols are built, ensuring that patients receive treatments that are both safe and effective2.
Integrating CBD into Post-operative Care
The implications of the ECS Brands' study extend far beyond just validating CBD's potential benefits. For surgeons, this research offers a roadmap for integrating CBD into post-operative care protocols. With empirical evidence at hand, they can make informed decisions, tailoring pain management strategies to individual patient needs. This personalized approach to care, backed by solid research, ensures that patients receive the best possible outcomes while minimizing potential risks3.
A New Era in Post-operative Pain Management
The medical community stands at the cusp of a new era in post-operative pain management, with CBD emerging as a potential game-changer. The ECS Brands' 90-day clinical study is a testament to CBD's potential and paves the way for its broader acceptance in clinical settings. As more surgeons become interested in using CBD, armed with the knowledge from such studies, we can anticipate a future where post-operative care is not just about managing pain but enhancing the overall quality of recovery for patients4.
Market Dynamics: Reflecting the Growing Interest
The CBD Revolution in the Health and Wellness Market
The health and wellness industry is currently witnessing a revolution, with CBD-infused products taking center stage1. From tinctures and oils to edibles and topicals, the range of CBD products available to consumers has expanded exponentially. This surge is not merely a trend; it's a reflection of the increasing awareness of CBD's potential therapeutic benefits. As more people become educated about CBD, its natural properties, and its potential health benefits, the demand for high-quality CBD products has skyrocketed.
Empirical Evidence and Consumer Trust
The rise in CBD's popularity is not just based on anecdotal evidence. Numerous studies, clinical trials, and research papers have delved into the potential benefits of CBD, providing empirical evidence that supports many of the claims made by CBD proponents2. This scientific backing has played a pivotal role in building consumer trust. When consumers know that a product's claims are supported by research, they are more likely to try it and recommend it to others.
Surgeons and CBD: A Growing Interest
The sentiments of the medical community, especially surgeons interested in using CBD, mirror this growing consumer trust. Surgeons are always on the lookout for effective, non-addictive, and safe pain management solutions for their patients. With the potential benefits of CBD coming to the fore, many surgeons are keen to explore how this natural compound can be integrated into post-operative care protocols3. Their interest is not just a nod to the latest trend but a genuine curiosity driven by the desire to provide the best care for their patients.
A Promising Future for CBD in Medical Care
The trajectory of CBD in the health and wellness sector suggests a promising future, not just as a consumer product but as a potential staple in medical care. As more research is conducted and more medical professionals, including surgeons, advocate for its use, CBD is poised to play a significant role in shaping the future of pain management and overall patient care4.
Conclusion and The Road Ahead
he Unveiling Potential of CBD in Post-Operative Care
In recent years, the medical landscape has been abuzz with discussions about the therapeutic potential of CBD, especially in the realm of post-operative care1. As surgeries often lead to acute pain, the quest for effective pain management solutions has never been more crucial. Traditional painkillers, while effective, come with a slew of side effects and the looming threat of addiction. Enter CBD: a natural compound that promises pain relief without the associated high or potential for addiction.
Medical Professionals' Growing Trust in CBD
The shift towards CBD isn't just a fleeting trend; it's backed by empirical evidence and the growing trust of medical professionals. Surgeons, who often grapple with the challenge of ensuring their patients' comfort post-surgery, are particularly interested in the potential benefits of CBD2. Their interest is not just a nod to the latest trend but a genuine curiosity driven by the desire to provide the best care for their patients. As more surgeons express interest in using CBD, it underscores the compound's potential in revolutionizing post-operative care.
Research and CBD: Building a Strong Foundation
The foundation of CBD's growing acceptance in the medical community is the increasing body of research supporting its benefits. Numerous studies have delved into the analgesic properties of CBD, suggesting its efficacy in managing post-operative pain3. As more research is conducted, the medical community's understanding of CBD deepens, solidifying its position as a promising tool in post-operative care.
A Bright Future for CBD in Medical Care
Looking ahead, the trajectory of CBD in the medical sector is undeniably upward. With its potential benefits in pain management, anti-inflammation, and even anxiety reduction, CBD is poised to become an integral part of post-operative care protocols4. As the medical community continues to explore and understand CBD's benefits, it stands as a testament to the compound's potential in shaping the future of medical care, especially in post-operative pain management.

HSS stands as a beacon of excellence in the medical world, especially in musculoskeletal health[^1^]. Their commitment to research, innovation, and education makes them a trusted name globally. As they continue to explore the potential of compounds like CBD, they play a pivotal role in shaping the future of post-operative care.

Resources:

Surgeons Interested in Using Cannabidiol (CBD) as a Potential Pain Management Strategy After Surgery

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