Lidocaine Patch as Treatment for Neuropathic Pain: Our Experience
DOI:
https://doi.org/10.25759/spmfr.245Keywords:
Lidocaine, Neuralgia/drug therapy, Transdermal PatchAbstract
Introduction: Chronic pain is a very debilitating and underestimated condition, affecting patients’ quality of life. Its prevalence is around 20% in adult European population and about 36.7% in Portugal adult population. Neuropathic pain represents about 7% - 8% of all chronic pain conditions in Europe and accounts for more depression, anxiety and sleep disorders than any other type of pain. For this reason, chronic neuropathic pain is now considered as a common public health problem with a major impact on health related costs.
Objectives: To understand patients’ satisfaction regarding topical treatment with lidocaine patches in some clinical conditions of neuropathic localized chronic pain.
Methods: A telephone survey of 6 questions specifically designed for this study was applied to all the patients followed in consultation for chronic neuropathic pain to whom lidocaine patches were recommended. This retrospective study took place in Hospital de Braga, at the Physical and Rehabilitation Medicine Service, between December 2015 and December 2016.
Results: Fifty two patients in such conditions were identified, but only 31 were included (27 women and 4 men). Four groups were then formed, according to diagnosis or consultation purpose: Pain after surgical intervention (n=21), peripheral canal syndromes (n=3), post-herpetic neuralgia (n=1) and Morton neuroma (n=6). Twenty four patients (77%) were satisfied with the recommended treatment with lidocaine patches, with post-herpetic neuralgia attending for the biggest score for pain relief (50%), followed by pain after surgical intervention group (47% in pain relief). Eighteen out of 31 patients also tried other therapeutic options, including pharmacological or physiotherapy.
Conclusion: Despite some limitations of this study, such as small simple size and heterogeneity between the groups, most of the patients felt satisfied with lidocaine patches treatment. This study enhances the potential of using lidocaine patches in different contexts of localized neuropathic pain other than Post-herpetic Neuralgia. The authors suggest, however, the need for more clinical studies to sustainably propose treatment with lidocaine patches in localized neuropathic pain.
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References
Derry S, Wiffen PJ, Moore RA, Quinlan J. Topical lidocaine for neuropathic
pain in adults. Cochrane Database Syst Rev. 2014;7:CD010958. doi:
1002/14651858.CD010958.pub2.
Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH. Physical
activity and exercise for chronic pain in adults: an overview of Cochrane
Reviews. Cochrane Database Syst Rev. 2017;4:CD011279. doi:
1002/14651858.CD011279.pub3.
Azevedo LF, Costa-Pereira A, Mendonça L, Dias CC, Castro-Lopes JM.
Epidemiology of chronic pain: a population-based nationwide study on its
prevalence, characteristics and associated disability in Portugal. J Pain.
;13:773-83. doi: 10.1016/j.jpain.2012.05.012.
Azevedo LF, Costa-Pereira A, Mendonça L, Dias CC, Castro-Lopes JM.
Epidemiology of chronic pain: a population-based nationwide study on its
prevalence, characteristics and associated disability in Portugal. J Pain.
;13:773-83. doi: 10.1016/j.jpain.2012.05.012.
Haanpää M, Treede RD. Diagnosis and classifi cation of neuropathic pain
epidemiology and impact of neuropathic pain. Pain Med. 2010; 28:1-6.
Hall GC, Carroll D, McQuay HJ. Primary care incidence and treatment of
four neuropathic pain conditions: A descriptive study, 2002–2005. BMC
Fam Pract. 2008;9:26. doi: 10.1186/1471-2296-9-26.
Attal N, Cruccu G, Baron R, Haanpää M, Hansson P, Jensen TS, et al. EFNS
guidelines on the pharmacological treatment of neuropathic pain: 2010
revision. Eur J Neurol. 2010;17:1113-e88. doi: 10.1111/j.1468-
2010.02999.x.
Jensen TS, Baron R, Haanpää M, Kalso E, Loeser JD, Rice AS, Treede RD.
A new definition of neuropathic pain. Pain. 2011;152:2204-5. doi:
1016/j.pain.2011.06.017.
Sommer C, Cruccu G. Topical treatment of peripheral neuropathic pain:
applying the evidence. J Pain Symptom Manage. 2017;53:614-29. doi:
1016/j.jpainsymman.2016.09.015.
Centre for Clinical Practice at NICE (UK). Neuropathic Pain: The
Pharmacological Management of Neuropathic Pain in Adults in Nonspecialist
Settings [Internet]. London: National Institute for Health and Care
Excellence; 2013. [accessed Jan 2018] Available from
http://www.ncbi.nlm.nih.gov/books/NBK266257/
Moore RA, Derry S, Aldington D, Cole P, Wiffen PJ. Amitriptyline for
neuropathic pain in adults. Cochrane Database Syst Rev.
;7:CD008242. doi: 10.1002/14651858.CD008242.pub3.
Saarto T, Wiffen PJ. Antidepressants for neuropathic pain. Cochrane
Database Syst Rev. 2007;4: CD005454. doi:
1002/14651858.CD005454.pub2
Moore RA, Wiffen PJ, Derry S, Toelle T, Rice AS. Gabapentin for chronic
neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev.
;4:CD007938. doi: 10.1002/14651858.CD007938.pub3.
Lunn MP, Hughes RA, Wiffen PJ. Duloxetine for treating painful neuropathy,
chronic pain or fibromyalgia. Cochrane Database Syst Rev.
;1:CD007115. doi: 10.1002/14651858.CD007115.pub3.
Sultan A, Gaskell H, Derry S, Moore RA. Duloxetine for painful diabetic
neuropathy and fibromyalgia pain: systematic review of randomised trials.
BMC Neurol. 2008;8:29. doi: 10.1186/1471-2377-8-29.
Moore RA, Straube S, Aldington D. Pain measures and cut-offs - ‘no worse
than mild pain’ as a simple, universal outcome. Anaesthesia. 2013;68:400-
doi: 10.1111/anae.12148.
Laklouk M, Baranidharan G. Profile of the capsaicin 8% patch for the
management of neuropathic pain associated with postherpetic neuralgia:
safety, efficacy, and patient acceptability. Patient Prefer Adherence.
;10:1913-18.
European Medicines Agency. Anexo I - Resumo das Características do
Medicamento Capsaicina. 1–29, 2010.
Derry S, Moore RA. Topical capsaicin (low concentration) for chronic
neuropathic pain in adults. Cochrane Database Syst Rev.
;9:CD010111. doi: 10.1002/14651858.CD010111.
Derry S, Sven-Rice A, Cole P, Tan T, Moore RA. Topical capsaicin (high
concentration) for chronic neuropathic pain in adults. Cochrane Database
Syst Rev. 2013;2:CD007393. doi: 10.1002/14651858.CD007393.pub3.
Campbell BJ, Rowbotham M, Davies PS, Jacob P 3rd, Benowitz NL.
Systemic absorption of topical lidocaine in normal volunteers, patients with
post-herpetic neuralgia, and patients with acute herpes zoster. J Pharm
Sci. 2002;91:1343-50.
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