Fleming Julia Ann, O'Connor Bradley David
Professor Tess Cramond Multidisciplinary Pain Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.
Pain Res Manag. 2009 Sep-Oct;14(5):381-8. doi: 10.1155/2009/723179.
There are few reports of the use of the lidocaine 5% patch (L5%P) for neuropathic pain (NP) in the cancer patient. Within a comprehensive cancer centre, L5%P has been prescribed by the Pain and Palliative Care Service (Peter McCallum Cancer Centre, East Melbourne, Victoria, Australia) for selected patients with NP since 2001.
To retrospectively audit the use of L5%P within a comprehensive cancer centre.
All L5%P prescriptions up to January 2009 were listed and patient medical records were searched to determine neuropathic pain syndromes treated, the presence of allodynia, previous analgesic medications, treatment duration and outcome.
L5%P was prescribed for 97 patients, most frequently for persistent postsurgical NP (n=26), postherpetic neuralgia (n=24) and cancer-related NP (n=18). Six patients had no history of cancer and two patients never applied L5%P. Reviewers classed L5%P analgesic efficacy as 'potent' in 38% of patients with postherpetic neuralgia, 35% of patients with postsurgical pain, 27% of patients with NP after other treatments for cancer and 12% of patients with NP attributed to cancer alone. Allodynia featured in at least 60% of patients. Where allodynia was present, the efficacy of L5%P was assessed as 'potent' in 38% and 'partial' in 24%, but 'ineffective' in 26%, and 'causing worse pain' in 3.4% of patients. Treatment duration extended longer than one month in 52 patients, longer than two months in 29 patients and longer than one year in 13 patients. Therapy was ceased due to skin irritation in seven patients. The outcomes in relation to other reports are discussed.
The present data support trials of L5%P for cancer patients with NP syndromes associated with allodynia.
关于5%利多卡因贴剂（L5%P）用于癌症患者神经性疼痛（NP）的报道较少。自2001年以来，在一家综合性癌症中心，疼痛与姑息治疗服务部门（澳大利亚维多利亚州东墨尔本彼得·麦卡勒姆癌症中心）已为部分NP患者开具L5%P。
回顾性审核一家综合性癌症中心L5%P的使用情况。
列出截至2009年1月的所有L5%P处方，并查阅患者病历，以确定所治疗的神经性疼痛综合征、是否存在痛觉过敏、先前使用的止痛药物、治疗持续时间及结果。
97例患者使用了L5%P，最常见于持续性术后NP（n = 26）、带状疱疹后神经痛（n = 24）和癌症相关NP（n = 18）。6例患者无癌症病史，2例患者从未使用过L5%P。在带状疱疹后神经痛患者中，38%的患者、术后疼痛患者中35%的患者、癌症其他治疗后NP患者中27%的患者以及仅因癌症导致NP的患者中12%的患者，评审人员将L5%P的镇痛效果归类为“强效”。至少60%的患者存在痛觉过敏。在存在痛觉过敏的患者中，38%的患者L5%P疗效被评估为“强效”，24%的患者为“部分有效”，但26%的患者“无效”，3.4%的患者“导致疼痛加重”。52例患者治疗持续时间超过1个月，29例患者超过2个月，13例患者超过1年。7例患者因皮肤刺激而停止治疗。讨论了与其他报道相关的结果。
目前的数据支持对伴有痛觉过敏的NP综合征癌症患者进行L5%P试验。
