Effects of single and repeated applications of a eutectic mixture of local anaesthetics (EMLA) cream on spontaneous and evoked pain in post-herpetic neuralgia.
The analgesic effects of single and repeated applications of a eutectic mixture of local anaesthetics (EMLA) cream on both spontaneous and evoked pains were evaluated in 11 patients with post-herpetic neuralgia (PHN). Detection thresholds, pain thresholds and the responses to suprathreshold mechanical and thermal stimuli were quantitatively determined at baseline, 30 min after the first application and after a series of daily applications over six consecutive days (duration of application: 5 h/day). In the acute situation, EMLA produced an overall anaesthetic effect without significantly reducing spontaneous ongoing pain and mechanical allodynia. Repeated applications significantly reduced paroxysmal pain and both the dynamic and static subtypes of mechanical hyperalgesia. The effects on spontaneous ongoing pain were more variable. They were inversely correlated to the magnitude of the thermal deficit at baseline, and were significant only in patients with dynamic mechano-allodynia. Pathophysiological implications of these results are discussed.
Attal
N
N
Unité d'Evaluation et de Traitement de la Douleur Hôpital Ambroise Paré, Boulogne, France.
Brasseur
L
L
Chauvin
M
M
Bouhassira
D
D
D000368:Aged; D000369:Aged, 80 and over; D019162:Anesthetics, Combined / Q000009:adverse effects / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006566:Herpesviridae Infections / Q000150:complications*; D006358:Hot Temperature; D006801:Humans; D006930:Hyperalgesia / Q000503:physiopathology; D008012:Lidocaine / Q000009:adverse effects / Q000627:therapeutic use*; D000077442:Lidocaine, Prilocaine Drug Combination; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy* / Q000209:etiology*; D010146:Pain / Q000503:physiopathology; D017288:Pain Threshold / Q000187:drug effects; D011318:Prilocaine / Q000009:adverse effects / Q000627:therapeutic use*; D012677:Sensation / Q000187:drug effects / Q000502:physiology
D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000077442:Lidocaine, Prilocaine Drug Combination; D011318:Prilocaine; D008012:Lidocaine