Department of Rehabilitation and Regenerative Medicine, NewYork-Presbyterian, The University Hospital of Columbia and Cornell, New York, NY, USA.
Department of Anesthesiology, NewYork-Presbyterian Hospital, Weill Cornell Medicine, New York, USA.
Curr Pain Headache Rep. 2021 Feb 25;25(3):18. doi: 10.1007/s11916-020-00934-z.
The objective of this systematic review is to present the available evidence for the utilization of the atypical opioids tapentadol, buprenorphine, and levorphanol for the treatment of neuropathic pain.
In total, 1619 articles were retrieved of which 10 studies were included. Of 5 included studies pertaining to tapentadol, 4 studies show tapentadol monotherapy to be effective for the treatment of diabetic peripheral neuropathy or chronic, radiating low back pain. Of the 3 studies included for buprenorphine, only one was a randomized controlled trial found not to have a statistically significant reduction in pain with TD buprenorphine likely due to very high withdrawal rates during the trial. Only 2 case reports were included from the available literature for levorphanol providing low-quality anecdotal evidence. The role of tapentadol, buprenorphine, and levorphanol for neuropathic pain conditions requires robust research including randomized controlled trials to evaluate their efficacy and safety.
本系统综述的目的是介绍使用非典型阿片类药物（盐酸他喷他多、丁丙诺啡和左啡诺）治疗神经病理性疼痛的现有证据。
共检索到 1619 篇文章，其中纳入了 10 项研究。在纳入的 5 项关于盐酸他喷他多的研究中，有 4 项研究表明盐酸他喷他多单药治疗糖尿病周围神经痛或慢性放射性腰痛有效。纳入的 3 项丁丙诺啡研究中，只有一项随机对照试验发现丁丙诺啡治疗的疼痛无统计学意义的减轻，这可能是由于试验期间非常高的退出率。左啡诺仅从现有文献中纳入了 2 篇病例报告，提供了低质量的轶事证据。盐酸他喷他多、丁丙诺啡和左啡诺治疗神经病理性疼痛的作用需要包括随机对照试验在内的强有力的研究来评估其疗效和安全性。
