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Inicio Medicina Clínica (English Edition) Cannabis hyperemesis syndrome: Incidence and treatment with topical capsaicin
Journal Information
Vol. 159. Issue 4.
Pages 183-186 (August 2022)
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Vol. 159. Issue 4.
Pages 183-186 (August 2022)
Brief report
Cannabis hyperemesis syndrome: Incidence and treatment with topical capsaicin
Síndrome de hiperémesis por cannabis: incidencia y tratamiento con capsaicina tópica
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5
Guillermo Burillo-Putzea,b,
Corresponding author
gburillo@telefonica.net

Corresponding author.
, David Trujillo-Burilloa, Jose Carlos García-Hernandeza, M. Angeles López-Hernándezb,c, Iván Hernández-Ramosb,c, Isabel Ramos-Suárezb,d, John R. Richardsd
a Departamento de Medicina Física y Farmacología, Universidad de La Laguna, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
b Grupo de investigación Urgencias y toxicología clínica: patologías agudas y procesos asistenciales (GRUCATOX), Universidad de La Laguna, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
c Servicio de Urgencias, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
d Department of Emergency Medicine, University of California, Davis Medical Center, Davis, CA, United States
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Abstract
Introduction

There are few studies in Spain on cannabinoid hyperemesis syndrome (CHS), as well as on the use of topical capsaicin as a treatment.

Methods

Retrospective study of patients over 14 years of age seen in a hospital emergency department during 2018 and 2019 with a diagnosis of CHS based on the following criteria: compatible clinical picture, cannabis use less than 48 h and positive urine cannabis test. Epidemiological and clinical variables, attendance times and treatment (including use of topical capsaicin 0.075%) were collected.

Results

Fifty-nine attendances were studied, from 29 patients (4.4 cases/10,000 visits, 95% CI 2.8–4.7). Fifty per cent returned for CHS, differing only in more tobacco (P = 0.01) and cocaine (P = 0.031) use. Capsaicin was used in 74.6% of visits. The mean time to resolution of vomiting after application was 17.87 min.

Conclusions

Although probably underdiagnosed, CHS has a low incidence in the emergency department in Spain, with high patient recurrence. The use of capsaicin ointment is efficient and safe.

Keywords:
Cannabinoid hyperemesis syndrome
Cannabis
Capsaicin
Resumen
Introducción

Existen pocos estudios en España acerca del síndrome de hiperémesis cannabinoide (SHC), así como sobre el uso de capsaicina tópica para su tratamiento.

Métodos

Estudio retrospectivo de pacientes mayores de 14 años atendidos en un servicio de urgencias hospitalario durante 2018 y 2019 con diagnóstico de SHC con base en los siguientes criterios: cuadro clínico compatible, consumo de cannabis menor de 48 h y test de cannabis en orina positivo. Se recogieron variables epidemiológicas, clínicas, tiempos asistenciales y tratamiento (incluyendo el uso de capsaicina tópica al 0,075%).

Resultados

Se estudiaron 59 asistencias de 29 pacientes (4,4 casos/10.000 visitas, IC 95% 2,8−4,7). Un 50% volvieron a urgencias por SHC, diferenciándose estos solo en más consumo de tabaco (p = 0,01) y cocaína (p = 0,031). En un 74,6% de las visitas se utilizó capsaicina. El tiempo medio de resolución de los vómitos tras su aplicación fue de 17,87 min.

Conclusiones

Aunque probablemente esté infradiagnosticado, el SHC presenta una incidencia baja en las urgencias en España, y con alta reincidencia de los pacientes. El uso de pomada de capsaicina es eficiente y seguro.

Palabras clave:
Síndrome de hiperémesis cannabinoide
Cannabis
Capsaicina

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