Cannabidiol as an Alternative Analgesic for Acute Dental Pain.

Journal of dental research Pub Date : 2024-03-01 Epub Date: 2023-11-01 DOI:10.1177/00220345231200814
V Chrepa, S Villasenor, A Mauney, G Kotsakis, L Macpherson
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Abstract

Odontogenic pain can be debilitating, and nonopioid analgesic options are limited. This randomized placebo-controlled clinical trial aimed to assess the effectiveness and safety of cannabidiol (CBD) as an analgesic for patients with emergency acute dental pain. Sixty-one patients with moderate to severe toothache were randomized into 3 groups: CBD10 (CBD 10 mg/kg), CBD20 (CBD 20 mg/kg), and placebo. We administered a single dose of respective oral solution and monitored the subjects for 3 h. The primary outcome measure was the numerical pain differences using a visual analog scale (VAS) from baseline within and among the groups. Secondary outcome measures included ordinal pain intensity differences, the onset of significant pain relief, maximum pain relief, changes in bite force within and among the groups, psychoactive effects, mood changes, and other adverse events. Both CBD groups resulted in significant VAS pain reduction compared to their baseline and the placebo group, with a maximum median VAS pain reduction of 73% from baseline pain at the 180-min time point (P < 0.05). CBD20 experienced a faster onset of significant pain relief than CBD10 (15 versus 30 min after drug administration), and both groups reached maximum pain relief at 180-min. Number needed to treat was 3.1 for CBD10 and 2.4 for CBD20. Intragroup comparisons showed a significant increase in bite forces in both CBD groups (P < 0.05) but not in the placebo group (P > 0.05). CBD20 resulted in a significant difference in mean percent bite force change in the 90- and 180-min time points compared to the placebo group (P < 0.05). Compared to placebo, sedation, diarrhea, and abdominal pain were significantly associated with the CBD groups (P < 0.05). There were no other significant psychoactive or mood change effects. This randomized trial provides the first clinical evidence that oral CBD can be an effective and safe analgesic for dental pain.

大麻二酚作为急性牙痛的替代镇痛药。
牙源性疼痛可能会使人衰弱,非鸦片类镇痛的选择有限。这项随机安慰剂对照临床试验旨在评估大麻二酚(CBD)作为紧急急性牙痛患者止痛药的有效性和安全性。61名中度至重度牙痛患者被随机分为3组:CBD10(CBD 10 mg/kg)、CBD20(CBD 20 mg/kg)和安慰剂。我们分别给予单剂量口服溶液,并对受试者进行3小时的监测。主要的结果测量是使用视觉模拟量表(VAS)从基线开始测量各组内部和组之间的疼痛数值差异。次要结果测量包括顺序疼痛强度差异、显著疼痛缓解的开始、最大疼痛缓解、组内和组间咬合力的变化、精神活性影响、情绪变化和其他不良事件。与基线和安慰剂组相比,两个CBD组的VAS疼痛显著减轻,在180分钟的时间点,VAS疼痛的最大中位数从基线疼痛减轻了73%(P<0.05)。CBD20的显著疼痛缓解速度比CBD10更快(给药后15分钟和30分钟),两组在180分钟时都达到了最大疼痛缓解。CBD10和CBD20需要治疗的数量分别为3.1和2.4。组内比较显示,两个CBD组的咬合力显著增加(P<0.05),但安慰剂组没有(P>0.05)。与安慰剂组相比,CBD20导致90和180分钟时间点的平均咬合力变化百分比显著差异(P<0.05),腹痛与CBD组显著相关(P<0.05)。没有其他显著的精神活动或情绪变化影响。这项随机试验首次提供了临床证据,证明口服CBD是一种有效、安全的牙痛镇痛药。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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