[Topical pharmacologic approach with 5% lidocaine medicated plaster in the treatment of localized neuropathic pain].
The treatment of neuropathic pain is a medical challenge. The responsiveness to the different classes of drugs is often unsatisfactory and frequently associated to a wide range of side effects. International guidelines suggest for the "localized" neuropathic pain the topical treatment with 5% lidocaine medicated plaster, alone or associated to systemic drugs, as the first choice since its favorable efficacy and tolerability profile. Many clinical experiences support the rationale for using 5% lidocaine medicated plaster in different kinds of localized neuropathic pain, such as postherpetic and trigeminal neuralgia, compressive syndromes, painful diabetic polyneuropathy and pain secondary to trauma or surgical interventions. This paper reports a series of clinical cases whose heterogeneity suggests the wide burden of applicability of the topical 5% lidocaine, either alone and associated to systemic drugs. All the described conditions were characterized by a highly intense pain, not adequately controlled by actual medications, which improved after the use of topical lidocaine. The good response to lidocaine allowed the reduction, of even the withdrawal, of concurrent drugs and improved the patients' quality of life.
Clinica Neurologica, Dipartimento di Medicina Sperimentale e Clinica, Università Politecnica delle Marche Ancona, Italia - l.provinciali@univpm.it.
L
L
Provinciali
S
S
Lattanzi
R
R
Chiarlone
A
A
Fogliardi
F
F
Intelligente
C
C
Irace
M
M
Lanzilotta
R
R
Palomba
E
E
Storelli
M
M
Zampi
D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D019917:Blood Vessel Prosthesis Implantation; D020516:Brachial Plexus Neuropathies / Q000188:drug therapy / Q000209:etiology; D001943:Breast Neoplasms / Q000601:surgery; D002277:Carcinoma / Q000532:radiotherapy / Q000601:surgery; D002445:Celiac Artery / Q000601:surgery; D002968:Clavicle / Q000293:injuries / Q000601:surgery; D004599:Electric Stimulation Therapy; D005260:Female; D005593:Fracture Fixation, Internal; D059685:Herniorrhaphy; D006801:Humans; D007869:Leg Injuries / Q000601:surgery; D008012:Lidocaine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D016462:Mammaplasty; D017538:Mesenteric Artery, Superior / Q000601:surgery; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy* / Q000209:etiology; D051474:Neuralgia, Postherpetic / Q000188:drug therapy; D010149:Postoperative Pain / Q000188:drug therapy / Q000209:etiology; D011832:Radiation Injuries / Q000188:drug therapy / Q000209:etiology; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D013119:Spinal Cord Injuries / Q000209:etiology / Q000503:physiopathology; D014067:Tonsillar Neoplasms / Q000532:radiotherapy / Q000601:surgery; D014277:Trigeminal Neuralgia / Q000188:drug therapy
D000779:Anesthetics, Local; D008012:Lidocaine