Analgesic effect of lidocaine patch 5% in the treatment of acute herpes zoster: a double-blind and vehicle-controlled study.
OBJECTIVE
Although lidocaine patch 5% has been widely used for postherpetic neuralgia, its analgesic effect on the intense pain associated with acute herpes zoster has not been investigated because of its potential hazard to damaged skin.


METHODS
Forty-six patients suffering from moderate to severe pain caused by acute herpes zoster infection (within 4 weeks of onset) were enrolled in a randomized, double-blind, vehicle-controlled, parallel study. Lidocaine patch 5% or vehicle patch were applied to the intact portion of the painful skin area without blisters at 12-hour intervals twice a day for 2 consecutive days. Analgesic efficacy and side effect profiles were assessed before and 48 hours after patch application.


RESULTS
We found that both groups of patients experienced significant pain relief during rest and movement. Differences of mean reduction of pain intensity between the two groups were 14.7 (4.7-24.8, P = 0.005) during rest and 10.4 (1.6-19.3, P = 0.007) during movement, favoring the lidocaine patch. The lidocaine patch produced a greater percentage change in a patient's global impression than the vehicle patch. The incidence and severity of adverse events were low with both treatments.


CONCLUSIONS
This study demonstrates that lidocaine patch 5%, applied twice a day, could serve as a well tolerated and effective modality to relieve moderate to severe pain associated with acute herpes zoster presumably through its pharmacological action and physical barrier effect on sensitized skin.
Lin
Pei-Lin
PL
Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
Fan
Shou-Zen
SZ
Huang
Chi-Hsiang
CH
Huang
Hui-Hsun
HH
Tsai
Ming-Cheng
MC
Lin
Chen-Jung
CJ
Sun
Wei-Zen
WZ
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006562:Herpes Zoster / Q000188:drug therapy*; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D014677:Pharmaceutical Vehicles
D000779:Anesthetics, Local; D014677:Pharmaceutical Vehicles; D008012:Lidocaine