Management of neuropathic pain after surgical and non-surgical trauma with lidocaine 5% patches: study of 40 consecutive cases.
OBJECTIVE
To determine the efficacy of lidocaine 5% patches [Versatis, commercialised by Grünenthal GmbH, Aachen, Germany] in patients with PNCCP.


BACKGROUND
This study focuses on chronic pain states of a neuropathic nature, located at the scar or over a larger area of the skin around the scar. This post-operative/post-traumatic neuropathic chronic cutaneous pain (PNCCP) may be a side-effect of any incision of the skin in the context of a surgical procedure or a traumatic event.


METHODS
A single-centre, open, non-randomised, prospective study was performed in a university hospital referral centre for patients with chronic neuropathic pain after surgical or non-surgical trauma. Forty consecutive patients with chronic PNCCP, a VAS score > or =5, a LANSS score > or =12, and a stable consumption of pain medication were prospectively evaluated. All patients were given lidocaine 5% patches, following a 12 h on/off schedule.


METHODS
Visual analogue scale (VAS) and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scorings were performed pretreatment (day 0), on the 28th day (4 weeks), and after 84 days (12 weeks).


RESULTS
The mean pretreatment VAS score (VAS(0)) was 7.225 +/- 1.209, and the mean pretreatment LANSS score (LANSS(0)) was 18.60 +/- 2.610. The number of patients with a VAS score <5 at the latest follow-up (VAS(84)) was 21 (52.5%). Mean VAS(84) was 4.625 +/- 1.675. Seventeen patients (42.5%) had a LANSS score <12 at the latest follow-up. Overall mean LANSS(84) was 12.85 +/- 3.093.


CONCLUSIONS
Lidocaine 5% patches seem to be an effective treatment of post-surgical and post-traumatic pain. These results should be supported with randomised and placebo-controlled studies with larger sample sizes and longer follow-ups.
Hans
Guy
G
Department of Anaesthesiology and Multidisciplinary Pain Centre, Antwerp University Hospital, Wilrijkstraat 10, Edegem, Belgium. guy.hans@uza.be
Joukes
Ellen
E
Verhulst
Johanna
J
Vercauteren
Marcel
M
D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D009994:Osmolar Concentration; D010149:Postoperative Pain / Q000188:drug therapy; D012107:Research Design; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000150:complications / Q000188:drug therapy
D008012:Lidocaine