• P Beaulieu and A S C Rice.
• Département d'anesthésiologie, CHUM, Hôtel-Dieu, 3840 Saint-Urbain, Montréal, Québec, H2W 1T8, Canada. pierre.beaulieu@umontreal.ca
• Ann Fr Anesth Reanim. 2002 Jun 1; 21 (6): 493-508.

ObjectiveTo present the cannabinoid system together with recent findings on the pharmacology of these compounds in the treatment of pain.Data SourcesSearch through Medline database of articles published in French and English since 1966. Also use of other publications such as books on cannabis.Study SelectionAll the relevant documents within the theme of this review were used.Data ExtractionAll the data linked to the present topic were searched.Data SynthesisRecent advances have dramatically increased our understanding of cannabinoid pharmacology. The psychoactive constituents of Cannabis sativa have been isolated, synthetic cannabinoids described and an endocannabinoid system identified, together with its component receptors and ligands. Strong laboratory evidence now underwrites anecdotal claims of cannabinoid analgesia in inflammatory and neuropathic pain. Sites of analgesic action have been identified in brain, spinal cord and the periphery, with the latter two presenting attractive targets for divorcing the analgesic and psychotrophic effects of cannabinoids. Clinical trials are now required, but are hindered by a paucity of cannabinoids of suitable bioavailability and therapeutic ratio.ConclusionThe cannabinoid system is a major target in the treatment of pain and its therapeutic potential should be assessed in the near future by the performance of new clinical trials.

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