Fogliardi A, Brunori C
Unità Operativa Terapia del Dolore e C.P. ASUR Marche Area Vasta 1 Fano, Pesaro e Urbino, Italia -
Minerva Med. 2013 Dec;104(6):631-7.
The aim of this paper is to confirm the efficacy and safety in clinical practice of 5% lidocaine medicated plaster (LMP) in the treatment of localized neuropathic pain.
Retrospective, observational study carried out in the period 2006-2012, in patients with various forms of localized peripheral neuropathic pain treated with LMP. Only patients with at least one follow-up visit after prescription of the drug were assessed.
One hundred and one patients were assessable, 60.4% of whom suffered from postherpetic neuralgia (PHN), while the remainder reported mainly post-traumatic/post-surgical neuropathic pain and other superficial localized neuralgias. In baseline conditions, the mean pain intensity measured on the NRS was 6.1. The median treatment time with LMP was 41 days, at the end of which there was a 64% fall in NRS, with no significant differences between the patients with PHN or other localized neuralgias. A better NRS reduction trend was also observed in those patients who, in our study, started treatment with LMP from the first visit, compared with those patients to whom LMP was prescribed later. The tolerability was good, with few adverse events at the application site, which led to suspension of treatment in just three cases.
In our experience, LMP proved to be an effective and well-tolerated drug in the treatment of PHN and other superficial localized neuralgias. This observation is in agreement with the international guidelines, which suggest LMP as first line treatment for the management of localized peripheral neuropathic pain.
本文旨在证实5%利多卡因药用贴剂(LMP)治疗局限性神经性疼痛的临床疗效和安全性。
2006年至2012年期间开展的一项回顾性观察研究,纳入接受LMP治疗的各种类型局限性周围神经性疼痛患者。仅评估在开具药物后至少有一次随访的患者。
101例患者可进行评估,其中60.4%患有带状疱疹后神经痛(PHN),其余主要报告为创伤后/手术后神经性疼痛及其他浅表局限性神经痛。基线时,NRS测得的平均疼痛强度为6.1。LMP的中位治疗时间为41天,治疗结束时NRS下降了64%,PHN患者与其他局限性神经痛患者之间无显著差异。在本研究中,首次就诊即开始使用LMP治疗的患者,与之后才开具LMP的患者相比,NRS下降趋势更佳。耐受性良好,用药部位不良事件较少,仅3例导致治疗中断。
根据我们的经验,LMP被证明是治疗PHN和其他浅表局限性神经痛的一种有效且耐受性良好的药物。这一观察结果与国际指南一致,指南建议将LMP作为局限性周围神经性疼痛管理的一线治疗药物。