CBD Oil For Knee Pain After Surgery

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Multiple studies have showcased that THC and CBD offer an alternative to opioids and other pain medicines CBD oil can help with surgery recovery by promoting neurogenesis and mitigating pain signals from the nerves to the brain. Here we review the best CBD oils for surgery recovery according to our meticulous research. Utilization of topical CBD in supplement to multimodal analgesia did not reduce pain or opioid consumption, or improve sleep scores following TKA. These results suggest that the local effects of topical CBD are not beneficial for providing additional pain relief after TKA.

Recovering after knee surgery: How CBD and marijuana can help

With America being slow to warm to understanding cannabis’s role in medicine, a clinical trial sponsored by McMaster University in Canada is looking into the role of cannabis in post-surgical pain. Photo by iStock / Getty Images Plus

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With knee pain, everything seems to be a chore. From climbing stairs, to getting in-and-out of the car, individuals that suffer from prolonged knee soreness and discomfort often benefit from surgery, with many stating that after-care can be almost as difficult as the pain itself. In fact, Googling “knee surgery aftercare” often brings up results in how to avoid surgery altogether.

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However, delaying surgery can have subtle effects that patients often don’t realize. BoneSmart, a website by AESCULAP Implant Systems, found research on why delaying surgery could bring additional complications. From a risk of deformities to the increased inability to manage pain, BoneSmart also found that delaying the procedure could prolong time under anesthesia.

Recovering after knee surgery: How CBD and marijuana can help Back to video

The Arthritis Foundation also echoed the research of others like BoneSmart on the internet but added the caveat that most patients could make an informed decision with knowledge of weighing the pros and cons of having immediate surgery or choosing to delay the procedure.

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Additionally, the Foundation shared a study by the Agency for Healthcare Research and Quality, showcasing the fact that demand for the total knee replacement procedure has been steadily rising since 2011, as has patient questions about avoiding opioid addiction and additional therapies available in after care.

Multiple studies have shown that THC and CBD offer an alternative to opioids and other pain medicines but often patients don’t know where to look for proven studies on the effects of cannabis on pain within the body. As Brandon May from Clinical Pain Advisor shares, “Research examining the therapeutic effects of CBD remains limited, as the majority of clinical studies focus on THC, which binds CB1 receptors rather than on CBD itself.”

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The role of THC and CBD

With America being slow to warm to understanding cannabis’s role in medicine, a clinical trial sponsored by McMaster University in Canada is looking into the role of cannabis in post-surgical pain. In their trial brief, they explain:

“Medicinal cannabis has begun to emerge as a potential therapy for pain reduction and produces effects largely due to 2 active components: (1) cannabidiol (CBD), and (2) tetrahydrocannabinol (THC). Studies of CBD have shown analgesic, anti-inflammatory, and anti-anxiety properties, but without the psychoactive effects (feeling ‘high’) that THC produces. This study will assess the feasibility of a definitive trial to explore whether adding CBD vs. placebo to usual care before and after surgery can reduce the rate of persistent post-surgical pain after total knee replacement. This study will randomize 40 patients to receive either CBD or placebo and follow them for six months to confirm our ability to recruit patients, adhere to protocol, and capture full outcome data for at least 90% of patients.”

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As the U.S. continues to struggle in hosting trials and studies due to the classification of cannabis, pressure continues to mount on all involved in healthcare to explore additional therapies.

How technology is improving patient outcomes

With many patients choosing to move forward with surgery, there seems to be a feeling of apprehension of what to expect after, as each individual’s recovery plan is usually customized. Medicare’s Comprehensive Care for Joint Replacement Model started recommending immediate discharge after surgery instead of placing patients in after-care facilities, which some say has added depth to the opioid-epidemic for those unable to discontinue pain medicine at proper times.

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Dr. Michael Suk, chair of Geisinger’s Musculoskeletal Institute, shared recently with Modern Healthcare that while after-surgery care is set individually with each patient, certain best practices are a guideline. These include timeframes for check-ins with the health care team and offering specific resources for education. Noticing a need to offer home-bound patients a way to connect to resources throughout their recovery, Dr. Suk and his team partnered with Force Therapeutics to offer an app that allows patients to not only have touchpoints with nurses and gives access to detailed care plans. Geisinger’s strategic partnership has helped create big cost savings, and helped patients feel empowered.

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Other technologists and entrepreneurs have taken notice of recent trends in helping patients stay connected after surgery. The MyMobility app has been rolled out at Hoag Orthopedic Institute to allow patients to showcase their rehabilitation statistics (steps taken, amount of time spent in activity) so the care team can make further recommendations for follow-up care.

Technology is helping care teams to better align best practices with patients who may need extra support or experience hesitation at completing physical therapy at home with the added bonus that more frequent communication may help identity an opioid addiction, with more eyes and ears on care. However, patients must feel empowered to share that they are dependent on opioids, which often is kept silent due to a myriad of reasons.

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Tackling opioid addictions after surgery

A 2018 report looked at opioid use after knee replacement surgery and found:

  • While the number of opioid pills prescribed is dropping from 85 pills to 82, surgeons often feel pressure to prescribe more opioids than they feel are necessary.
  • Patients were often prescribed more than double the 20 morphine milligram equivalents (MMEs) dose when many were given opioids of 50+ MMEs, which poses not only an overdose risk, but could lead to complications to the liver and body.
  • Most interesting, patients undergoing a knee replacement surgery reported an incidence of later dependence of 15.2% versus the overall average of 12%, (an increase from a rate of 9% of a 2017 study.)

With opioid addiction facing unprecedented scrutiny, doctors and rehabilitation specialists are not only looking to new technologies to combat a dependence on painkillers, but also demonstrating a want to understand new ways of treating ancient issues of pain.

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Here’s the bottom line

Survey data indicates that the use of cannabis is common among patients with chronic pain[2] and patients who use it for this indication typically report it to be an effective treatment.[3] Majorities further report that cannabis possesses fewer side effects than conventional pain medications and that it provides greater symptom management than opioids.[4]” (NORML.org)

NORML, a national organization committed to revamping the U.S.’ marijuana believes in the power of cannabis in relieving pain and other organizations are starting to post their own guides for patients. The Arthritis Foundation, The Rheumatoid Arthritis Support Network, and many more organizations are starting to give their members new information on CBD and THC for pain. Even more, other studies are popping up from around the world, hoping to recruit individuals who are recovering from knee surgery to identify the benefits of THC and CBD in after-care.

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If you’re readying for surgery, consider discussing CBD and THC with your medical practitioner and care team. Not only might the compounds play a role in decreasing a long-term dependence on opioids, but they may also provide other benefits as well.

TheFreshToast.com, a U.S. lifestyle site, that contributes lifestyle content and, with their partnership with 600,000 physicians via Skipta, medical marijuana information to The GrowthOp.

Want to keep up to date on what’s happening in the world of cannabis? Subscribe to the Cannabis Post newsletter for weekly insights into the industry, what insiders will be talking about and content from across the Postmedia Network.

Best CBD Oil for Surgery Recovery: Top Brands in 2022

If you have a planned surgery soon, you may be wondering how you can reduce the pain and overall discomfort after the operation.

This is where CBD steps in.

CBD is one of the most popular natural compounds that can modulate pain signaling and reduce inflammation, which is also the root source of pain.

Acute inflammation usually stems from injuries, and hyperalgesia — increased sensitivity to pain — is a result of nerve damage, that may happen during such a serious procedure as surgery.

In this article, I’ll show you how CBD may assist you in the recovery period after surgery; I’ll also recommend some of the most reputable brands that make high-quality lab-tested CBD oils, based on my years of experience as a CBD user.

Best CBD Oils for Surgery Recovery (Top Brands for 2022)

1. Royal CBD

Get 15% off all Royal CBD products. Use code “ CFAH ” at checkout.

  • Organic, US-grown hemp
  • Supercritical CO2 extraction
  • Broad product range
  • High-strength options are available
  • Well-designed formulas
  • Flavored with natural ingredients
  • Complete third-party testing profile
  • 30-days Money Back Guarantee
  • A little bit more expensive than the market’s average (but still worth the price)
  • Not available locally

Royal CBD was launched in 2018 resulting from the need to contrast mediocrity on the market by introducing true full-spectrum CBD formulations from organic hemp. They started as a small artisan brand, the company has become a true hemp powerhouse.

Royal CBD makes its products with supercritical CO2 extraction, ensuring that they maintain consistent potency and purity throughout batches — without using too high temperatures or toxic solvents on the way.

Royal CBD offers a broad selection of full-spectrum and broad-spectrum formulas, including CBD oils, capsules, gummies, honey sticks, topicals, and CBD for pets.

The Royal CBD oil is available in four concentrations: 250 mg, 500 mg, 1000 mg, and a whopping 2400 mg of full-spectrum CBD. They come in three flavors — mint, vanilla, and berry — except for the strongest variant which you can only buy in the unflavored option. That’s because adding flavorings would compromise the original potency and terpene profile of the products.

As full-spectrum extracts, the Royal CBD oils leverage the entourage effect, which is a phenomenon where all cannabinoids and terpenes from cannabis work together to amplify the therapeutic strength of the final product.

2. Gold Bee

  • Organic hemp
  • CO2 extraction
  • Infused with superfoods
  • Full-spectrum and broad-spectrum CBD
  • Up to 2500 mg of total CBD
  • Flavored with natural ingredients
  • Pet products
  • 30-day Money Back Guarantee
  • Limited potency options
  • No isolate-based products

If you’re searching for the best CBD oils for surgery recovery that come from all-natural ingredients, Gold Bee should meet your expectations. The brand specializes in full-spectrum CBD extracts infused with superfoods, such as coconut oil or raw honey from Brazillian rainforests.

You can choose from products like CBD oil, capsules, gummies, topicals, and CBD for pets. On top of the CBD collection, Gold Bee also has CBG, CBN, and Kava products in its store.

The Gold Bee CBD oil is sold in two strengths: 1200 mg and 2400 mg. You can choose between two flavors: Kiwi and Lychee, both of which are sweetened with honey and stevia. These are great CBD oils for flavor chasers.

At 88 mg of CBD per bottle, the stronger CBD oil may be a good option after major surgeries. Like Royal CBD, Gold Bee tests all its products in an ISO-certified laboratory for potency and purity.

3. CBDPure

  • Organic hemp from Colorado
  • Full-spectrum products
  • Well-thought-out formulations
  • 90-day Money Back Guarantee
  • One of the pioneer brands in the USA
  • Narrow product range
  • Lack of flavored products
  • Premium pricing

I often recommend CBDPure to beginners who don’t know where to start but would like to experience the potential of full-spectrum CBD products. This company was established in 2016, but unlike other pioneers, CBDPure decided to focus on mastering its traditional formulas instead of expanding the world of novel CBD formats.

The current product selection of CBDPure is a bit modest, featuring CBD oil, softgels, cream, and low-strength pet oil. Interestingly, the pet oil was previously in the human category of CBD oils.

You can choose between three potencies: 300 mg, 600 mg, and 1000 mg. On one hand, these concentrations are good if you want to test different dosages, but may not bring enough CBD to make your post-surgical supplementation cost-effective.

How I Picked the Best CBD Oils for Surgery Recovery

No two CBD oils are made the same. That’s because the market lacks regulations in terms of manufacturing and labeling standards. There are many great brands out there, but there’s an equal number of fly-by-night manufacturers who will have no problems selling you mislabeled and contaminated products.

Here’s how I shop for CBD; follow these tips to make a well-informed decision on your purchase, whether you’re buying CBD oil for surgery recovery online or somewhere near you.

Hemp Source

Hemp plants have bioaccumulative properties. In other words, they can absorb every substance from their environment — including the good and the bad ones. The goal is to grow hemp in a way that will enable it to draw up only the good while minimizing the risk of absorbing toxins.

The best CBD oils for surgery recovery are made from organic hemp that is grown here in the USA. Due to strict quality-control regulations, such plants are cultivated without pesticides and herbicides, so they’re clean from the toxins that are bad for your health. Instead, they yield CBD-rich flowers that make for the perfect sourcing materials.

Extraction Method

There are several ways to extract CBD, from ethanol to cooking oils to CO2 and hydrocarbon solvents.

Alcohol and cooking oils are usually used to make food and tinctures. But, products like CBD oils, may lack efficacy on a large scale.

That’s why more companies are using CO2 extraction to make high-quality CBD oils for surgery recovery.

CO2 is put in its supercritical state, where it acts both as a gas and liquid. This way, it can effectively strip the hemp plant from its natural chemicals, dissipating once the process is done.

The least safe option is using hydrocarbon solvents. Yes, they’re cheaper than CO2 and ethanol, but they’re also highly flammable and difficult to purge, creating a risk of leaving toxic residue at the bottom of an extract.

Cannabinoid Spectrum

Full-spectrum CBD oils are superior for surgery recovery to isolate-based products because they leverage the entourage effect.

This term describes a phenomenon where cannabinoids, terpenes, and flavonoids, demonstrate a synergism that can have a profound impact on the efficacy of the end product.

Looking for a real-life example of the entourage effect?

Just take a look at the interactions between CBD and THC.

CBD can mitigate the psychotropic potential of THC by blocking the sites of receptors to which the intoxicating compound tries to bind. This, in turn, reduces the incidence of anxiety and paranoia in cannabis users.

On the other hand, isolated CBD may be ineffective unless a certain dosage threshold is achieved; this is known as a bell-shaped dose-response. Scientists from the University of Jerusalem found a way to overcome this obstacle by adding a whole-plant cannabis extract to the formulation.

CBD Potency

The potency, also known as the strength of your CBD oil, tells you how much CBD is in one milliliter of your product.

For example, the Royal CBD oil high-strength full-spectrum CBD oil contains 2400 mg of CBD in a 30-mL bottle, translating into 83.3 mg of CBD per mL.

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High-potency oils are better if you want to address severe pain during surgery recovery, while lower strengths work well for users who are just getting started and aren’t sure how their bodies will react to different doses of CBD.

The potency of CBD oil is considered cost-effective if one bottle lasts you for a minimum of 30 days.

Additional Ingredients

Some CBD oils for surgery recovery may contain additional ingredients that are included to boost the analgesic and anti-inflammatory effects of cannabidiol.

Your manufacturer may infuse its CBD oils with the following supplements:

  • Turmeric
  • Chamomile
  • Terpenes (b-caryophyllene, humulene, myrcene, linalool, geraniol)
  • Honey
  • Vitamin D
  • Vitamin C

However, you need to watch out for any ingredients that you wouldn’t use in your kitchen — or anything that raises your suspicions for that matter.

Including artificial ingredients like colorings, flavorings, preservatives, and stabilizers go against the philosophy of CBD use, which is to support wellness and promote homeostasis in the body.

Flavor

Full-spectrum CBD oil isn’t the best-tasting product out there; it carries an earthy, slightly nutty taste that is anything but enjoyable. However, you can improve the flavor profile of your CBD oil by choosing products infused with terpenes and other food-grade flavorings.

However, once again, keep in mind to avoid CBD oils infused with artificial colorings and flavorings; nobody knows what is hiding under the terms “colorings” and “flavorings,” so it’s better to steer clear of such “inventions.”

Texture

Sometimes, you can tell a lot about the quality of CBD oil by simply looking at its texture and consistency. Full-spectrum CBD oils are thick and gold-to-brown(or green) depending on the level of filtration. The more potent the product, the more viscous it should be.

If your CBD oil claims to have 3000 mg of CBD but it looks like a thin transparent liquid, you’re probably looking at a blend of isolates, which is not even close to the whole-plant philosophy.

Purity (Third-Party Testing)

Lab testing is essential if you want to make sure that you’re buying a safe product. As I mentioned at the beginning of the article, the CBD market isn’t regulated by any federal agency, so it’s the consumer’s responsibility to do their research on their vendors.

CBD brands can send their product samples to third-party laboratories to run meticulous tests regarding their potency and purity. This includes the CBD content, cannabinoid, and terpene profile, the presence of THC, and common contaminants such as pesticides, herbicides, solvents, microbial impurities, and more.

If a product passes the test, it receives a certificate of analysis (COA). The company can show it on its website or send it to customers upon purchase via email.

Companies that hide their lab reports are untrustworthy because they fail to meet essential transparency standards.

Does CBD Oil Speed Up Surgery Recovery?

  • In a study from Transplantation Proceedings, the authors proved that CBD might help reduce chronic pain after kidney transplants.
  • A 2019 clinical study found that CBD and other plant-based cannabinoids demonstrated the same efficacy as antibiotics in the post-surgery healing process.
  • According to a 2019 survey that was shown during the 2019 Society of Anesthesia and Sleep Medicine Annual Meeting, surgeons are interested in using CBD as a potential medication for post-surgical pain control. , even with over-the-counter painkillers due to the risk of negative drug-to-drug interactions.
  • More research will bring us a deeper insight into the benefits of CBD oil for surgery recovery.

Why People Are Using CBD for Surgery Recovery

CBD isn’t the first-line treatment for post-surgical pain. Doctors typically prescribe conventional painkillers, such as non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and other analgesics.

Unfortunately, these medications — although effective in the short-term perspective — can do more harm than good in the long run.

Regular use of NSAIDs may lead to bloatedness, stomach pain, ulcers, gas, heartburn, hypertension, diarrhea, nausea, vomiting, and constipation.

Opioids, in turn, may trigger vomiting, nausea, urinary retention, constipation, impaired cognitive performance, drowsiness, and compromised respiratory function. Addiction is also of high concern to post-surgical patients.

Given this, let’s take a look at what studies are saying about using CBD oil for surgery recovery.

Studies on CBD & Surgery Recovery

  • A 2019 clinical trial showed that six patients with third-molar extractions benefited from CBD when it comes to pain relief. The patients also experienced reduced swelling and irritation of the affected area.
  • In a 2018 study on people after kidney transplants, CBD appeared to reduce post-surgical pain. The subjects were taking between 50 and 150 mg. Although the authors noticed side effects, such as dry mouth, nausea, dizziness, drowsiness, and intermittent heat fluctuation, they evaluated that the benefits outweighed the risks.
  • A 2019 study observed CBD’s effects on chronic pain patients who were taking opioids. Over 50% of the sample reported that they were able to cut their intake of opioids or eliminate them after eight weeks of supplementing CBD daily. Almost all patients reported improvements in their quality of life.

CBD for Nausea and Vomiting

John Hopkin’s Medicine University states that individuals after surgery may experience nausea and vomiting as a side effect. They may also report pain, swelling, and soreness around the incision site, and the inability to fall asleep.

A study published in the British Journal of Pharmacology found that CBD reduced nausea and vomiting and rats and shrew subjects.

Another research paper suggested that CBD and other cannabinoids might assist patients in treating nausea and vomiting from chemotherapy and other treatments.

CBD for Pain

The research team that conducted a study published in the journal Therapeutics and Clinical Risk Management found that CBD had analgesic and anti-inflammatory properties that might help people manage intractable pain.

In another study from the journal Clinical Rehabilitation, the authors reported that CBD and THC helped people improve their pain markers, especially in patients with dysfunctions of the central nervous systems.

The patients had spinal cord injury, multiple sclerosis, brachial plexus damage, and limb amputation caused by neurofibromatosis.

Brachial plexus is a name for the network of nerves that send signals from the spinal cord to the arms, shoulders, and hands. Meanwhile, neurofibromatosis is a genetic disease of the nervous system that causes the malformation of nerve cells.

CBD for Sleep

Research from 2019 analyzed CBD’s effects on 103 adult subjects and found that the compound reduced their anxiety and improved sleep.

A 2017 systematic review of the literature published in the journal Current Psychiatry Reports suggested that CBD might ease insomnia and REM sleep behavior disorders.

The latter condition is characterized by experiencing unpleasant dreams and abrupt movements during REM sleep.

How CBD Oil Works to Speed Up Surgery Recovery

CBD’s painkilling and anti-nausea effects result from several mechanisms.

To begin with, CBD ensures that the endocannabinoid system (ECS) produces more of its natural cannabinoids and slows down their breakdown; as a result, your pain threshold increases and you can achieve a better mood.

CBD is also a potent anti-inflammatory compound. This effect occurs through the cannabinoid’s interaction with the CB2 receptor in the immune system.

On top of that, CBD mitigates pain signaling by acting on the TRPV1 vanilloid receptor — hence its analgesic effects.

As for nausea and vomiting, CBD’s therapeutic effects are mostly attributed to its indirect activation of the 5-HT1A receptors in the dorsal raphe nucleus.

This region of the brain is one of its most sensitive sites and controls the processing of rewards and pleasures.

5-HT1A also regulates the release of serotonin, which is a hormone responsible for regulating happiness, mood, and anxiety.

In clinical studies on animal models, CBD has demonstrated analgesic and anxiolytic (anti-anxiety) effects due to the aforementioned interaction.

The Pros & Cons of Using CBD Oil for Surgery Recovery

The Pros

  • CBD has been repeatedly shown by animal and human studies to provide therapeutic effects to individuals undergoing surgery recovery.
  • CBD’s safety is more favorable than that of NSAIDs of opioids.
  • CBD is unlikely to cause dependence in humans and animals. Its potential for abuse is the same as with placebo.

The Cons

  • We need more clinical studies to draw definitive conclusions about CBD oil’s efficacy during surgery recovery and related conditions.
  • Despite its good safety profile, CBD can still cause a few mild side effects in large doses, including changes in appetite, diarrhea, tiredness, and dry mouth.
  • CBD isn’t officially approved as a treatment for other conditions than epilepsy.

CBD vs Alternative Treatments for Surgery Recovery

Research shows that curcumin may be beneficial for post-surgery symptoms. In a 2014 study, the scientists observed that curcumin reduced post-surgical pain and helped speed up recovery.

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The authors also supported the use of curcumin as a monotherapy or adjunct therapy to surgery recovery.

CBD can go hand in hand with curcumin in this matter. That’s why many brands make CBD oils infused with turmeric (or isolated curcumin); it creates a more “complete” effect.

CBD Dosage: How Much CBD Oil Should You Take for Surgery Recovery,

Unfortunately, there are no standard dosage guidelines or recommendations for people undergoing surgery recovery.

If you want to make sure you get the most out of your supplementation, start with a low dose, such as 10–15 mg, and observe the results for a day or two. If nothing changes in your pain levels after that time, you can add another 15 mg to the dosage — and continue until you find the amount that works best for you.

Consulting a doctor first is also a wise decision. If the doctor is experienced in cannabis and CBD, it’s all the better. A consultation with a medical professional will help you establish the right dosage and routine to avoid interactions with other medications.

CBD Oil vs Other Forms of CBD for Surgery Recovery

CBD oil is the golden mean for people undergoing surgery recovery. It combines relatively high bioavailability with a fast onset time and long duration.

Bioavailability refers to the amount of CBD that ends up in your bloodstream upon ingestion.

For oral CBD products, the bioavailability can reach 20% max.

Sublingual products, such as CBD oil, have around 35% bioavailability.

For vapes, this figure rises to 56%.

However, the effects of vaporized CBD tend to dissipate quickly, usually lasting up to 3 hours. In contrast, the effects of CBD oil can linger for even 6 hours.

CBD oil is also better than gummies or capsules for surgery recovery because the CBD gets absorbed through tiny capillary glands under the tongue. From there, it can reach the bloodstream, bypassing the liver and the first-pass effect.

CBD oil’s analgesic and calming effects should be noticeable within 15–20 minutes after administration. The final onset depends on your weight, metabolism, and whether you take CBD oil on a full or empty stomach.

Key Takeaways on the Best CBD Oil for Surgery Recovery

CBD is a versatile health supplement. Its health benefits range from anti-inflammatory to anxiolytic to analgesic and neuroprotective. CBD can also reduce nausea and vomiting — all thanks to its relationship with the ECS.

As it turns out, CBD can also be useful for individuals undergoing surgery recovery. Patients using CBD report reduced pain and inflammation, elevated mood, and fewer cases of vomiting.

Compared to conventional painkillers such as opioids and NSAIDs, CBD is not only effective but also has a remarkable safety profile.

The key is to find a high-quality product with the right attests and certificates. If you’re in a rush, feel free to use my recommendations; I also encourage you to do your research because doing so will make you an informed customer — and being one is the best defense against scammers.

Sources:

  1. Cuñetti, L., Manzo, L., Peyraube, R., Arnaiz, J., Curi, L., & Orihuela, S. (2018). Chronic Pain Treatment With Cannabidiol in Kidney Transplant Patients in Uruguay. Transplantation Proceedings, 50(2), 461–464. https://doi.org/10.1016/j.transproceed.2017.12.042[1]
  2. Puisys, A., Auzbikaviciute, V., Kubilius, R., Linkevicius, R., Razukevicius, D., & Linkevicius, T. (2019, March 11). Postoperative Healing Assessment Using Cannabinoids in Oral Surgery.
  3. (2019, October 18). Surgeons Interested in Using Cannabidiol (CBD) as a Potential Pain Management Strategy After Surgery. Retrieved from https://news.hss.edu/surgeons-interested-in-using-cannabidiol-cbd-as-a-potential-pain-management-strategy-after-surgery/
  4. Cunetti, L. op. cit.
  5. Rong, C. op. cit.
  6. Capano, A., Weaver, R., & Burkman, E. (2020). Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study. Postgraduate medicine, 132(1), 56–61. https://doi.org/10.1080/00325481.2019.1685298[6]
  7. Parker, L. A., Rock, E. M., & Limebeer, C. L. (2011). Regulation of nausea and vomiting by cannabinoids. British journal of pharmacology, 163(7), 1411–1422. https://doi.org/10.1111/j.1476-5381.2010.01176.x
  8. Grimison, P., Mersiades, A., Kirby, A., Lintzeris, N., Morton, R., Haber, P., Olver, I., Walsh, A., McGregor, I., Cheung, Y., Tognela, A., Hahn, C., Briscoe, K., Aghmesheh, M., Fox, P., Abdi, E., Clarke, S., Della-Fiorentina, S., Shannon, J., Gedye, C., … Stockler, M. (2020). Oral THC: CBD cannabis extract for refractory chemotherapy-induced nausea and vomiting: a randomized, placebo-controlled, phase II crossover trial. Annals of oncology: official journal of the European Society for Medical Oncology, 31(11), 1553–1560. https://doi.org/10.1016/j.annonc.2020.07.020
  9. Russo E. B. (2008). Cannabinoids in the management of difficult to treat pain. Therapeutics and clinical risk management, 4(1), 245–259. https://doi.org/10.2147/tcrm.s1928[9]
  10. Überall M. A. (2020). A Review of Scientific Evidence for THC: CBD oromucosal Spray (Nabiximols) in the Management of Chronic Pain. Journal of pain research, 13, 399–410. https://doi.org/10.2147/JPR.S240011[10]
  11. Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente journal, 23, 18–041. https://doi.org/10.7812/TPP/18-041[11]
  12. Babson, K. A., Sottile, J., & Morabito, D. (2017). Cannabis, Cannabinoids, and Sleep: a Review of the Literature. Current psychiatry reports, 19(4), 23. https://doi.org/10.1007/s11920-017-0775-9
Livvy Ashton

Livvy is a registered nurse (RN) and board-certified nurse midwife (CNM) in the state of New Jersey. After giving birth to her newborn daughter, Livvy stepped down from her full-time position at the Children’s Hospital of New Jersey. This gave her the opportunity to spend more time writing articles on all topics related to pregnancy and prenatal care.

Topical Cannabidiol (CBD) After Total Knee Arthroplasty Does Not Decrease Pain or Opioid Use: A Prospective Randomized Double-Blinded Placebo-Controlled Trial

Background: Multimodal analgesia has become the standard of care for pain management following total knee arthroplasty (TKA). Cannabidiol (CBD) is increasingly utilized in the postoperative period. The purpose of this study was to analyze the analgesic benefits of topical CBD following primary TKA.

Methods: In this randomized double-blinded placebo-controlled trial, 80 patients undergoing primary unilateral TKA applied topical CBD (CBD; n = 19), essential oil (EO; n = 21), CBD and essential oil (CBD + EO; n = 21), or placebo (PLA; n = 19) thrice daily around the knee for two weeks postoperatively. This supplemented a standardized multimodal analgesic protocol. Outcomes included visual analog scale (VAS) pain and numeric rating scale (NRS) sleep scores (collected on postoperative day [POD] 0, 1, 2, 7, 14, 42), and cumulative postoperative opioid use (42 days).

Results: Demographic characteristics were similar among the four cohorts. Preoperative VAS and NRS scores were similar among groups. The CBD cohort had a higher mean VAS pain score on POD 2 compared to the EO cohort (CBD: 69.9 ± 19.3 versus. EO: 51.0 ± 18.2; P = .013). No statistically significant differences existed for VAS scores at other times, and no statistically significant differences were observed for postoperative NRS sleep scores or postoperative opioid use at any time point.

Conclusion: Utilization of topical CBD in supplement to multimodal analgesia did not reduce pain or opioid consumption, or improve sleep scores following TKA. These results suggest that the local effects of topical CBD are not beneficial for providing additional pain relief after TKA.

Keywords: analgesia; cannabidiol (CBD); cannabis; opioid; total knee arthroplasty.

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