Kanai Akifumi, Kumaki Chie, Niki Yuriko, Suzuki Asaha, Tazawa Toshiharu, Okamoto Hirotsugu
Department of Anesthesiology, Kitasato University School of Medicine, Sagamihara, Japan.
Pain Med. 2009 Jul-Aug;10(5):902-9. doi: 10.1111/j.1526-4637.2009.00662.x.
Topical lidocaine patch is effective in the treatment of post-herpetic neuralgia (PHN), but not suited for paroxysmal pain because of the long latency of analgesia. Here, we examined the efficacy of 8% lidocaine pump spray (Xylocaine pump spray, XPS) for PHN.
Twenty-four patients with PHN were recruited into a randomized, double-blind, placebo-controlled, crossover study (study 1), and 100 patients with PHN were recruited into an open-labeled study (study 2). In study 1, patients were randomized to receive either XPS or saline placebo pump spray (PPS) applied to the painful skin areas. Following a 7-day period, patients were crossed over to receive the alternative treatment. In study 2, XPS was prescribed for patients who were advised to use the spray anytime, with a 2-hour gap between applications, for 2 weeks. The pain was assessed with a visual analogue scale (VAS). Details of use were noted in the diary.
In study 1, greater decreases in VAS of persistent pain followed application of XPS (baseline: 6.1 +/- 1.7 cm, 15-minute post-spray: 2.3 +/- 2.5 cm, mean +/- SD) than with PPS (6.1 +/- 1.7 cm, 5.7 +/- 1.6 cm, [P < 0.01]). The effect persisted for a median of 4.5 hours (range, 2 to 24 hours) after application. In study 2, 13 of 100 patients discontinued the treatment because of mild local side effects or insufficient effect. In the remaining 87 patients, XPS maintained significant pain relief relative to baseline throughout the 2-week period. Satisfaction with the therapy was reported by 79% of patients.
In both studies, XPS provided a significant improvement in PHN due to its prompt analgesia, lack of systemic side effects, and convenience of use.
外用利多卡因贴剂在治疗带状疱疹后神经痛（PHN）方面有效，但由于镇痛潜伏期长，不适合治疗阵发性疼痛。在此，我们研究了8%利多卡因泵式喷雾剂（赛罗卡因泵式喷雾剂，XPS）治疗PHN的疗效。
24例PHN患者被纳入一项随机、双盲、安慰剂对照、交叉研究（研究1），100例PHN患者被纳入一项开放标签研究（研究2）。在研究1中，患者被随机分配接受XPS或生理盐水安慰剂泵式喷雾剂（PPS），涂抹于疼痛的皮肤区域。7天后，患者交叉接受另一种治疗。在研究2中，为建议随时使用喷雾剂的患者开具XPS，每次使用间隔2小时，持续2周。用视觉模拟量表（VAS）评估疼痛。使用细节记录在日记中。
在研究1中，与PPS相比，应用XPS后持续性疼痛的VAS下降幅度更大（基线：6.1±1.7厘米，喷雾后15分钟：2.3±2.5厘米，平均值±标准差）（6.1±1.7厘米，5.7±1.6厘米，[P<0.01]）。应用后效果持续的中位数为4.5小时（范围为2至24小时）。在研究2中，100例患者中有13例因轻微局部副作用或效果不佳而停止治疗。在其余87例患者中，XPS在整个2周期间相对于基线保持了显著的疼痛缓解。79%的患者报告对该疗法满意。
在两项研究中，XPS因其起效迅速、无全身副作用且使用方便，在PHN治疗方面有显著改善。
