Study register · detailKohortenstudie · Cancer · 2026
Cannabis, Pain, and Complications: A Prospective Analysis of Cannabis Use, Opiate Consumption, and Postoperative Outcomes following Cancer-Related Abdominal Surgery.
Yee et al.·Annals of surgical oncologyImpact 1.6
HarmGRADEVery low1 citations
Samplen = 64 Pat.
Duration9/2021-3/2024
ControlNo cannabinoid use
EndpointPostoperative opioid…
Blindingn.a.
DesignKohortenstudie
”Key finding
Chronic cannabinoid users showed significantly higher postoperative pain scores and increased morphine consumption, but had no increased complication rate.
Summary
Prospective cohort study in n=64 patients (24 chronic cannabinoid users, 40 non-users) after abdominal cancer surgery. Chronic users with detectable cannabinoid levels showed significantly higher pain scores and increased morphine-equivalent consumption (8h postoperative: 28,8 vs. 9,8 MME, p=0,036; total hospitalization: 273 vs. 202,1 MME, p=0,046; prescribed: 150 vs. 100 MME, p=0,047; taken by day 30: 67,5 vs. 5 MME, p=0,03). Chronic users had fewer overall complications (22% vs. 51%, p=0,025), but similar rate of severe complications (8,7% vs. 9,8%, p=0,33).
P
PopulationAdults (≥21 years) with cancer who underwent abdominal surgery; chronic cannabinoid users (≥1×/week, last 3 months) vs. non-users; n=64
I
InterventionChronic cannabinoid use (measured preoperatively via plasma cannabinoids)
C
ControlNo cannabinoid use (last 12 months)
O
OutcomeChronic users had significantly higher postoperative pain scores and higher opioid consumption (MME 8h postoperative: 28,8 vs. 9,8, p=0,036; total hospitalization: 273 vs. 202,1 MME, p=0,046); fewer overall complications (22% vs. 51%, p=0,025), but no differences in severe complications (p=0,33)
Confidence in the evidence
Very lowLowModerateHigh
Very low
The lowest GRADE level, the effect estimate remains uncertain.
Downgraded for
Imprecision
Quality profile
Sample size★★★★★
Blinding—
Effect sizeHarm
Citations / year★★★★★
Authors
Yee EJ, Kirsch MJ, Miller OS, Sempio C, Bainbridge J, Klawitter J, Christians U, Madsen H, McCarter MD, Gleisner AL
Background: Cannabis use is increasing and is of particular interest to patients with cancer. There is no prospective data regarding its impact on perioperative outcomes. We asked how chronic usage of cannabis compounds (cannabinoids) impacted postoperative pain, opiate use, and complications after abdominal surgery for the treatment of cancer.
Patients And Methods: This was a single center prospective observational cohort study conducted from 9/2021-3/2024 of patients 21+ years old, undergoing abdominal surgery for the treatment of cancer, and either chronic cannabinoid users (>/=1x/week for last 3 months) or non-users (for the last year). Plasma cannabinoids were measured preoperatively on the day of surgery.
Results: Of 223 patients screened, 64 subjects completed enrollment (24 chronic cannabinoid users, 40 non-users). Most were male (67%) and underwent an open abdominal surgery (75%). 41% developed complications, 23% of which were severe (grade 3+) complications. Chronic users with detectable cannabinoid levels had significantly higher pain scores, which persisted in multivariable analysis. Chronic users also received significantly more morphine milligram equivalents (MME) (8-hours postoperatively: 28.8 vs 9.8, p=0.036, during the total hospitalization: 273 vs 202.1, p=0.046, prescribed: 150 vs 100, p=0.047, taken through POD30: 67.5 vs 5, p=0.03). Differences in MME prescribed and taken postoperatively persisted in multivariable analysis. Chronic users had fewer overall complications (5/23 (22%) vs 21/41 (51%), p=0.025), but similar frequency to non-users for severe complications (2/23 (8.7%) vs 4/41 (9.8%), p=0.33).
Conclusions: Chronic cannabinoid use increased postoperative pain and MME use for patients undergoing abdominal surgery for the treatment of cancer, but did not increase complications. Further study regarding preoperative cannabinoid cessation and use of cannabinoids for postoperative pain is warranted.