Department of Anesthesiology., Centro Hospitalar de Leiria, EPE, Leiria, Portugal.
Department of Psychiatry, Centro Hospitalar e Universitário de São João, Porto, Portugal.
Pain Physician. 2020 Sep;23(5):E541-E548.
Neuropathic pain is a complex condition that is difficult to control and has a high impact on quality of life. 8% Capsaicin patch can be a therapeutic strategy in the treatment of peripheral neuropathic pain.
This study aims to (1) evaluate clinical efficacy and (2) tolerability of 8% capsaicin patch in a Pain Unit.
Retrospective observational study.
Portuguese Pain Unit.
A sample of 120 patients diagnosed with peripheral neuropathic pain, underwent treatment with the 8% capsaicin patch between February 2011 and February 2019 in a Portuguese Pain Unit. Patients were included in one of the following groups according to the etiology of pain: postherpetic neuralgia (PHN), chronic post-surgical pain (CPSP), post traumatic neuropathic pain (PTNP), diabetic neuropathy (DN), regional pain syndrome. complex I and II (CRPS I / II), HIV-associated neuropathy (HIVN), lumbar neuropathic pain (LNP), trigeminal neuralgia (TN) and other neuropathies (O). The evaluated parameters were: pain intensity according to unit protocol (numerical rating scale), pain characteristics, location, size of the painful area. The evolution of pain intensity after treatment (patients were considered as responders to therapy if the decrease in NRS was equal to or greater than 30%; patients with a decrease in NRS of 50% or more were also analyzed), the area of pain and the need for adjuvant analgesic therapy, as well as the tolerability to treatment and the identification of eventual predictors of its efficacy were evaluated, at 15 days, 8 weeks and 12 weeks after 8% capsaicin patch.
Of the 120 patients in the sample, 40.8% had a >= 30% decrease in basal pain intensity 15 days after treatment, 43.3% after 8 weeks and 45.0% after 12 weeks. 30.8% of patients had >= 50% decreased basal pain intensity 15 days after treatment, 27.5% after 8 weeks and 30.0% after 12 weeks. Pain area decreased in 36.7% of patients and 18.3% reduced chronic analgesic therapy within 12 weeks after 8% capsaicin patch application. There was only one case of intolerance to the treatment.
This study has the limitations inherent to a retrospective study. The study period was only 12 weeks and some diagnostic groups included a small number of patients.
Treatment of peripheral neuropathic pain with 8% capsaicin patch seem to be effective in the short and medium term, both in decreasing pain intensity and in reducing the painful area. Its application is tolerated by most patients.
神经病理性疼痛是一种难以控制且对生活质量有重大影响的复杂病症。8%辣椒素贴片可以成为治疗周围神经病理性疼痛的一种治疗策略。
本研究旨在（1）评估 8%辣椒素贴片在疼痛科的临床疗效，（2）评估 8%辣椒素贴片的耐受性。
回顾性观察性研究。
葡萄牙疼痛科。
2011 年 2 月至 2019 年 2 月期间，在葡萄牙疼痛科，对 120 名被诊断为周围神经病理性疼痛的患者进行 8%辣椒素贴片治疗。根据疼痛的病因，患者被归入以下组别之一：带状疱疹后神经痛（PHN）、慢性术后疼痛（CPSP）、创伤后神经病理性疼痛（PTNP）、糖尿病性神经病（DN）、复杂性区域疼痛综合征 I 和 II（CRPS I / II）、HIV 相关神经病（HIVN）、腰椎神经病（LNP）、三叉神经痛（TN）和其他神经病（O）。评估的参数包括：按单位方案（数字评分量表）评估的疼痛强度、疼痛特征、位置、疼痛区域的大小。评估治疗后疼痛强度的变化（如果 NRS 下降等于或大于 30%，则认为患者对治疗有反应；还分析了 NRS 下降 50%或更多的患者）、疼痛区域和辅助镇痛治疗的需求，以及治疗的耐受性，并评估了其疗效的潜在预测因素，在治疗后 15 天、8 周和 12 周时评估 8%辣椒素贴片。
在样本中的 120 名患者中，40.8%在治疗后 15 天疼痛强度的基础值下降>=30%，43.3%在 8 周后下降，45.0%在 12 周后下降。30.8%的患者在治疗后 15 天疼痛强度的基础值下降>=50%，27.5%在 8 周后下降，30.0%在 12 周后下降。36.7%的患者疼痛区域缩小，18.3%的患者在 8%辣椒素贴片应用后 12 周内减少慢性镇痛治疗。只有 1 例患者对治疗不耐受。
本研究具有回顾性研究固有的局限性。研究期间仅为 12 周，一些诊断组的患者人数较少。
用 8%辣椒素贴片治疗周围神经病理性疼痛在短期和中期似乎是有效的，既能降低疼痛强度，又能减少疼痛区域。它的应用被大多数患者所耐受。
