Ukusetshenziswa kwe-cannabis yezokwelapha ekwehliseni ama-opioid ezigulini ezinobuhlungu obungapheli

Ukunikeza iziguli ezinobuhlungu obungapheli bokubuyela emuva kanye ne-osteoarthritis (OA) ukufinyelela ku-cannabis yezokwelapha kunganciphisa noma kuqede ukusetshenziswa kwama-opioid ekulawulweni kobuhlungu, ngokusho kwezifundo ezimbili ezethulwe eMhlanganweni Wonyaka ka-2022 we-American Academy of Orthopedic Surgeons (AAOS). Iholwa uMseshi Omkhulu u-Asif M. Ilyas, MD, MBA, FAAOS, lolu cwaningo luphinde lwabonisa ukuthi ubuhlungu kanye nekhwalithi yemiphumela yokuphila kwaba ngcono ngemva kokuba iziguli zigunyazwe ngensangu yezokwelapha.     

Abantu baseMelika abayizigidi ezingamashumi amahlanu bahlushwa ubuhlungu obungapheli obungahlobene nomdlavuza, ovame ukwelashwa ngama-opioid. Nokho, kunesidingo sezinye izindlela zokwelapha. Ngo-2019, abantu abalinganiselwa ezigidini eziyi-10.1 abaneminyaka engu-12 noma ngaphezulu abasebenzisa kabi ama-opioid ngo-2019, ii-opioid kanye nokulutha kwe-opioid kuhlala kuphezulu kakhulu. Ukusetshenziswa kwensangu yezokwelapha kuye kwacwaningwa njengenye indlela yokwelapha i-opioid, kodwa ucwaningo olwengeziwe luyadingeka ukuze kubuyekezwe ukusebenza kahle, umthamo, nokuthi kungathinta kanjani ukusetshenziswa kwe-opioid ekulawuleni ubuhlungu.

"Esimeni senkinga ye-opioid yamanje, kufanele sihlonze ezinye izindlela ezingase zinciphise ukuthembela kuma-opioid ekulawuleni ubuhlungu," kusho uDkt. Ilyas, umqondisi wohlelo lwe-hand & upper extremity surgery fellowship at Rothman Orthopedic Institute kanye noprofesa wokuhlinzwa kwamathambo. eThomas Jefferson University Hospital ePhiladelphia. "Okwamanje, asikhuthazi ukusetshenziswa kwensangu yezokwelapha noma sithi iyindlela engcono, kodwa izifundo zethu zikhombisa amandla."

Ukusetshenziswa kweCannabis Yezokwelapha Ezinhlungwini Ezingapheli Emuva kanye Neziguli ze-OA

Lezi zifundo ezimbili zibuyekeze idatha yemiyalelo ye-opioid egcwele egcwaliselwe iziguli ezinobuhlungu obungapheli be-back kanye ne-OA ezigunyazwe ukufinyelela insangu yezokwelapha phakathi kukaFebhuwari 2018 noJulayi 2019. Isilinganiso se-morphine milligram equivalents (MME) ngosuku semiyalelo ye-opioid sagcwalisa izinyanga eziyisithupha ngaphambi kokufinyelela. insangu yezokwelapha yaqhathaniswa nezinyanga eziyisithupha ngemva kokuba iziguli zithole ukufinyelela.

Idatha engapheli ye-musculoskeletal non-cancer back pain ibonisiwe:

• Ukuncipha okuphawulekayo kwesilinganiso se-MME esiphelele ngosuku ngemva kwencwadi kadokotela ye-cannabis yezokwelapha, ukusuka ku-15.1 ukuya ku-11.0 (n=186).

• U-38.7% weziguli zehla zafinyelela ku-zero MME ngosuku.

• Iziguli eziqale ngaphansi kuka-15 MME ngosuku nangaphezulu kuka-15 MME ngosuku zibe nokwehla okukhulu, ukusuka ku-3.5 kuya ku-2.1 (n=134) kanye nama-44.9 kuya ku-33.9 (n=52). Amaphesenti eziguli ezehlela ku-zero MME ngosuku kulawa maqembu abengu-48.5% no-13.5%, ngokulandelana.

• Uma kuqhathaniswa nesisekelo (izinyanga ezintathu, eziyisithupha, neziyisishiyagalolunye), iziguli zibike ukushuba okuthuthukisiwe, imvamisa, nomsebenzi wansuku zonke ngemva kokusetshenziswa kwensangu yezokwelapha.

• Iziguli ezisebenzise izindlela ezimbili noma ngaphezulu zokuphatha iwunga yezokwelapha zibonise ukwehla okukhulu kwe-MME ngosuku, kusukela ku-13.2 kuya ku-9.5 (n=76).

Ukwelashwa kwe-OA, izinyathelo zemiphumela yesiguli zahlolwa ezinyangeni ezintathu, eziyisithupha, neziyisishiyagalolunye kulandela ukusetshenziswa kwensangu yezokwelapha. Ngemuva kokufinyelela ku-cannabis yezokwelapha, ucwaningo lubonise:

• Kube nokwehla okuphawulekayo kwesilinganiso se-MME ngosuku lwemiyalelo egcwaliswe iziguli, kusukela ku-18.2 kuya ku-9.8 (n=40). Isilinganiso sokwehla kwe-MME ngosuku sasingama-46.3%.

• Iphesenti leziguli ezehla lafinyelela ku-zero MME ngosuku lalingama-37.5%.

• Izibalo zobuhlungu beziguli zehla kakhulu, zisuka ku-6.6 (n=36) zaya ku-5.0 (n=26) no-5.4 (n=16), ezinyangeni ezintathu neziyisithupha, ngokulandelana.

• Izinga lempilo leGlobal Physical Health lenyuke kakhulu, lisuka ku-37.5 laya ku-41.4, ezinyangeni ezintathu.

"Ucwaningo lwethu lubonisa ukuthi i-cannabis yezokwelapha ingaba ukwelashwa okuphumelelayo kobuhlungu obungapheli bokubuyela emuva kanye ne-osteoarthritis, okungenzeka kusize ukunciphisa ukuthembela kuma-opioid," kusho uDkt. Ilyas. "Kodwa-ke, ucwaningo olwengeziwe luyadingeka ukuze kuqondwe kangcono imizila namaza, izehlakalo ezingezinhle ezingaba khona, kanye nemiphumela yesikhathi eside yokusetshenziswa kwensangu yezokwelapha. Okwamanje, odokotela kufanele basebenzise izinqumo ezabiwe neziguli zabo lapho becubungula i-cannabis yezokwelapha ezimweni zobuhlungu obungapheli be-musculoskeletal.