Treatment of localized neuropathic pain of different etiologies with the 5% lidocaine medicated plaster – a case series

Abstract

ObjectiveTo assess the efficacy and safety of the topical 5% lidocaine medicated plaster in the treatment of localized neuropathic pain.Study designThis was a case series at an Austrian pain clinic, using retrospective analysis.Patients and methodsData of 27 patients treated for localized neuropathic pain with the 5% lidocaine medicated plaster were retrospectively analyzed. Assessment included changes in overall pain intensity, in intensity of different pain qualities, and of hyperalgesia and allodynia, and changes in sleep quality.ResultsPatients (17 female, ten male; mean age 53.4±11.4 years) presented mainly with dorsalgia (16 patients) or postoperative/posttraumatic pain (seven patients); one patient suffered from both. The mean overall pain intensity prior to treatment with lidocaine medicated plaster was 8.4±1.2 on the 11-point Likert scale. In the majority of cases, the lidocaine plaster was applied concomitantly with preexisting pain medication (81.5% of the patients). During the 6-month observation period, overall mean pain intensity was reduced by almost 5 points (4.98) to 3.5±2.6. Substantial reductions were also observed for neuralgiform pain (5 points from 7.9±2.6 at baseline) and burning pain (3 points from 5.2±4.1). Sleep quality improved from 4.6±2.6 at baseline to 5.5±1.8. Stratification by pain diagnosis showed marked improvements in overall pain intensity for patients with dorsalgia or postoperative/posttraumatic pain. The lidocaine plaster was well tolerated.ConclusionOverall, topical treatment with the 5% lidocaine medicated plaster was associated with effective pain relief and was well tolerated.

The 5% Lidocaine-Medicated Plaster: Its Inclusion in International Treatment Guidelines for Treating Localized Neuropathic Pain, and Clinical Evidence Supporting its Use

“…All pain parameters were measured on an 11-point Likert scale (0 = not present to 10 = worst possible state). At the end of the observation period, the mean pain intensity score had decreased by 78%, from 8.6 at baseline to 1.9, and no adverse events were considered to be related to the 5% lidocaine-medicated plaster [85]. These findings are well in agreement with previous studies and case series in patients with post-surgical/post-traumatic pain [52].…”

“…Mean painful area decreased from 17.8 to 2.1 cm 2 (reduction of 87.6%)Bischoff et al [84]. Randomized, double-blind, placebo-controlled crossover trial216 at rest, 7 during movement, 8 during palpation (NRS)114 days with either lidocaine or placebo plaster/14-day washout period/14 days with alternative plasterChanges in pain intensity following treatment with lidocaine or placebo (summed pain intensity differences—SPID) were not significantly differentLikar et al [85]. Retrospective analysis, add-on to existing treatment regimens78.6 (Likert scale)1/2 to 2 plasters (12 h on)6 monthsPain intensity dropped by 6.7 points to 1.9

All data are expressed as the mean unless otherwise stated.

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“…The retrospective case series published by Likar et al in 2015 includes seven patients with post-surgical/post-traumatic pain, who were observed over a period of 6 months (Table 2) [85]. All pain parameters were measured on an 11-point Likert scale (0 = not present to 10 = worst possible state).…”

Comparative analgesic efficacy of ultrasound-guided nerve blocks induced by three anesthetics with different duration of action in the treatment of resistant neuropathic pain in the lower extremities

“…The primary treatment of the NP is non-surgical -it is treated with a combination of several medications in 3-4 steps 5, 22, 23 . The first-line treatment involves the application of antidepressants and anticonvulsants, the local application of drugs often in combination with opioids that are most often considered the second or third-line treatment 5,24,25 . There is neither unique way for the NP treatment nor unique combination of medications for the same type of pain.…”

“…The Special Interesting Group on Neuropathic Pain (NeuPSIG) was established within the framework of the International Association for the Study of Pain (IASP). According to the NeuPSIG definition, the interventional procedure is "an invasive procedure involving the delivery of drugs into the target location" 15,24 . The high vitamin D doses, local anesthetics (LA), magnesium, gentamicin with or without corticosteroids are currently most commonly used in the NP treatment [28][29][30][31][32] .…”