局部麻醉药全身给药治疗神经性疼痛是否有效？一项 Cochrane 综述的概要介绍及述评。
Is systemic administration of local anesthetic agents effective for relieving neuropathic pain? A Cochrane Review summary with commentary.
机构信息
Head of the Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy Tel.: +390815665538; E-mail:
出版信息
NeuroRehabilitation. 2020;47(2):247-249. doi: 10.3233/NRE-209006.
BACKGROUND
The role of systemic use of local anesthetics in the treatment of neuropathic pain (NP) is still unclear.
OBJECTIVE
To assess the efficacy and safety of systemic local anesthetics for NP.
METHODS
To summarize and to discuss the rehabilitation perspective on the published Cochrane Systematic Review "Systemic administration of local anesthetic agents to relieve neuropathic pain" by Challapalli V et al.RESULTS:The review included 30 RCTs including patients with NP treated with iv lidocaine, oral mexiletine, lidocaine and mexiletine, or oral tocainide. Low-to-moderate quality of the evidence suggest that intravenous lidocaine or oral mexiletine may slightly reduce NP vs placebo, but the efficacy of these drugs is comparable to anticonvulsants or morphine.
CONCLUSIONS
Systemic administration of local anesthetics is not supported by scientific evidence for pain relief as well as for functional improvement.
背景
局部麻醉药全身应用在治疗神经病理性疼痛（NP）中的作用仍不清楚。
目的
评估全身应用局部麻醉药治疗 NP 的疗效和安全性。
方法
对 Challapalli V 等人发表的 Cochrane 系统评价“局部麻醉剂全身给药缓解神经病理性疼痛”进行总结和讨论。
结果
该综述纳入了 30 项 RCT，包括接受静脉利多卡因、口服美西律、利多卡因和美西律或口服甲苯噻嗪治疗的 NP 患者。低-中等质量证据表明，静脉注射利多卡因或口服美西律可能会轻微减轻 NP 与安慰剂相比，但这些药物的疗效与抗惊厥药或吗啡相当。
结论
全身应用局部麻醉药在缓解疼痛和改善功能方面没有得到科学证据的支持。
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