Abstract
Introduction
Cannabinoid hyperemesis syndrome (CHS) is a condition that is being recognized and
treated more frequently in emergency departments (EDs) across the United States. Currently,
ED providers rely on antiemetics, antipsychotics and benzodiazepines to alleviate
the symptoms. Topical capsaicin, a transient receptor potential vanilloid 1 (TRPV1)
agonist, has been proposed in recent years as a low-cost and effective alternative
to the traditional antiemetic regimen when treating CHS. The aim of this systematic
review and meta-analysis is to demonstrate the reliability and the gaps of what is
known about this treatment modality.
Methods
Articles were extracted from PubMed, SCOPUS, and Google Scholar databases. Publication
dates ranged from the inception of the databases to October 2020. Initial searches
found 328 studies. After careful review and screening by two investigators, 7 studies
met the inclusion criteria and were included for our meta-analysis. Variables that
were evaluated included the prevalence of hospital admissions for patients treated
with capsaicin, time to relief of symptoms after capsaicin administration, and ED
length of stay (LOS). I-square and Q-statistic values were used to assess heterogeneity.
Results
Among the 7 studies, there was a total of 106 patients. Two studies reported time
to resolution of symptoms following capsaicin administration and ED LOS. Means for
these outcomes were 325 (95% CI 234–787) and 379 (95% CI 10–747) minutes respectively.
I-square was 44%, and Q-statistic was 11 with 6 degrees of freedom, with a p-value of 0.1.
Discussion
With acceptable time to resolution of symptoms after topical administration and ED
LOS, capsaicin appears to be an effective treatment option for symptomatic relief
of CHS. Further randomized controlled trials should be conducted to examine if it
is the more efficacious and efficient treatment for CHS across various care settings.
Keywords
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Article Info
Publication History
Published online: January 15, 2021
Accepted:
January 3,
2021
Received in revised form:
January 3,
2021
Received:
December 26,
2020
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
