Exploring the Possible Role of Cannabinoids in Managing Post-Cardiac Surgery Complications: A Narrative Review of Preclinical Evidence and a Call for Future Research Directions

Uri Pollak; Adi Avniel-Aran; Alexander M Binshtok; Omer Bar-Yosef; Ronald A Bronicki; Paul A Checchia; Yaron Finkelstein

doi:10.1097/FJC.0000000000001560

Exploring the Possible Role of Cannabinoids in Managing Post-Cardiac Surgery Complications: A Narrative Review of Preclinical Evidence and a Call for Future Research Directions

J Cardiovasc Pharmacol. 2024 Mar 14. doi: 10.1097/FJC.0000000000001560. Online ahead of print.

Authors

Uri Pollak^{1

2}, Adi Avniel-Aran^{1

2}, Alexander M Binshtok^{3

4}, Omer Bar-Yosef^{5

6}, Ronald A Bronicki^{7

8}, Paul A Checchia^{7

8}, Yaron Finkelstein^{9

10}

Affiliations

¹ Section of Pediatric Critical Care, Hadassah University Medical Center, Jerusalem, Israel.
² Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.
³ Department of Medical Neurobiology, Institute for Medical Research Israel-Canada, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel.
⁴ The Edmond and Lily Safra Center for Brain Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel.
⁵ Pediatric Neurology and Child Development, The Edmond and Lily Safra Children's Hospital; The Chaim Sheba Medical Center, Tel Hashomer, Israel.
⁶ Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
⁷ Department of Pediatrics, Critical Care Medicine and Cardiology, Baylor College of Medicine, Houston, TX, USA.
⁸ Pediatric Cardiovascular Intensive Care Unit, Texas Children's Hospital, Houston, TX, USA.
⁹ Faculty of Medicine, Division of Emergency Medicine, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
¹⁰ Faculty of Medicine, Division of Clinical Pharmacology and Toxicology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

PMID: 38498618
DOI: 10.1097/FJC.0000000000001560

Abstract

Open-heart surgery with cardiopulmonary bypass (CPB) often leads to complications including pain, systemic inflammation, and organ damage. Traditionally managed with opioids, these pain relief methods bring potential long-term risks, prompting the exploration of alternative treatments. The legalization of cannabis in various regions has reignited interest in cannabinoids, such as CBD, known for their anti-inflammatory, analgesic, and neuroprotective properties. Historical and ongoing research acknowledges the endocannabinoid system's crucial role in managing physiological processes, suggesting cannabinoids could offer therapeutic benefits in post-surgical recovery. Specifically, CBD has shown promise in managing pain, moderating immune responses, and mitigating ischemia/reperfusion injury, underscoring its potential in postoperative care. However, the translation of these findings into clinical practice faces challenges, highlighting the need for extensive research to establish effective, safe cannabinoid-based therapies for patients undergoing open-heart surgery. This narrative review advocates for a balanced approach, considering both the therapeutic potential of cannabinoids and the complexities of their integration into clinical settings.