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外用苯妥英钠治疗神经性疼痛。

Topical phenytoin for the treatment of neuropathic pain.

作者信息

Kopsky David J, Keppel Hesselink Jan M

机构信息

Institute for Neuropathic Pain, Amsterdam.

Institute for Neuropathic Pain, Bosch en Duin, the Netherlands.

出版信息

J Pain Res. 2017 Feb 27;10:469-473. doi: 10.2147/JPR.S129749. eCollection 2017.

DOI:10.2147/JPR.S129749
PMID:28280381
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5338949/
Abstract

We developed and tested a new putative analgesic cream, based on the anticonvulsant phenytoin in patients suffering from treatment refractory neuropathic pain. The use of commercial topical analgesics is not widespread due to the facts that capsaicin creams or patches can give rise to side effects, such as burning, and analgesic patches (e.g., lidocaine 5% patches) have complex handling, especially for geriatric patients. Only in a few countries, compounded creams based on tricyclic antidepressants or other (co-)analgesics are available. Such topical analgesic creams, however, are easy to administer and have a low propensity for inducing side effects. We, therefore, developed a new topical cream based on 5% and 10% phenytoin and described three successfully treated patients suffering from neuropathic pain. All patients were refractory to a number of other analgesics. In all patients, phenytoin cream was effective in reducing pain completely, without any side effects, and the tolerability was excellent. The onset of action of the phenytoin creams was within 30 minutes. Phenytoin cream might become a new treatment modality of the treatment of neuropathic pain.

摘要

我们研发并测试了一种基于抗惊厥药物苯妥英钠的新型止痛乳膏,用于治疗难治性神经性疼痛的患者。商业外用止痛剂的使用并不广泛,因为辣椒素乳膏或贴片可能会引起副作用,如灼烧感,而且止痛贴片(如5%利多卡因贴片)使用复杂,尤其对于老年患者。仅在少数国家有基于三环类抗抑郁药或其他(协同)止痛剂的复方乳膏。然而,此类外用止痛乳膏易于给药,且引起副作用的可能性较低。因此,我们研发了一种基于5%和10%苯妥英钠的新型外用乳膏,并描述了3例成功治疗的神经性疼痛患者。所有患者对多种其他止痛剂均无效。所有患者使用苯妥英钠乳膏后疼痛完全缓解,且无任何副作用,耐受性良好。苯妥英钠乳膏的起效时间在30分钟内。苯妥英钠乳膏可能成为治疗神经性疼痛的一种新的治疗方式。

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