Besson Marie, Desmeules Jules, Piguet Valérie
Service de pharmacologie et toxicologie cliniques, Centre multidisciplinaire de la douleur, HUG, Faculté de médecine 1envèe.
Rev Med Suisse. 2008 Jun 18;4(162):1498, 1500, 1502-4.
Neuropathic pain is challenging to treat, partly because of the systemic side effects of the commonly used medications. Therefore topical analgesics are potentially very usefull. Lidocain, capsaicin, amitriptyline and ketamine have been used topically on a pathophysiological basis and because of their favourable safety profile. Application of lidocain 5%, capsaicin 0.025-0.075% and doxepin 3.3% is effective, although moderately in peripheric neuropathic pain with allodynia and should be considered as a therapeutic option. However, this option should be evaluated on an individual basis. The efficacy of topical amitriptyline and ketamine is not demonstrated.
神经性疼痛的治疗颇具挑战性，部分原因在于常用药物的全身性副作用。因此，局部用镇痛药可能非常有用。利多卡因、辣椒素、阿米替林和氯胺酮已基于病理生理学原理并因其良好的安全性而被局部使用。5%的利多卡因、0.025 - 0.075%的辣椒素和3.3%的多塞平的应用是有效的，尽管对伴有痛觉过敏的外周神经性疼痛效果一般，应被视为一种治疗选择。然而，这种选择应根据个体情况进行评估。局部使用阿米替林和氯胺酮的疗效尚未得到证实。
