Macedo Rafael da Rocha, Santos João Paulo Gonçalves Dos, Lobato Emanuel Smith, Mendes João Pereira, Ikemoto Roberto Yukio, Rodrigues Luciano Miller Reis
Departamento de Ortopedia e Traumatologia, Hospital Ipiranga, São Paulo, SP, Brasil.
Disciplina de Ortopedia e Traumatologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil.
Rev Bras Ortop (Sao Paulo). 2021 Oct 28;56(5):601-614. doi: 10.1055/s-0041-1735911. eCollection 2021 Oct.
The present paper aims to evaluate the use of a 5% lidocaine patch to treat neuropathic pain after orthopedic procedures in comparison with therapeutic massage over surgical incisions. This is a prospective, randomized clinical trial with 37 patients who underwent orthopedic surgery from January 2015 to February 2017. The study included subjects aged 13 to 70 years old who underwent foot and ankle orthopedic surgery and presented neuropathic pain or hypersensitivity at the surgical incision site for at least 90 days after the procedure. All patients were assessed for pain (using the visual analog scale [VAS]) and quality of life (with the SF-36 questionnaire) at the beginning of the treatment and after 30, 60, and 90 days. Although the treatment improved pain in both groups, subjects using the lidocaine patch presented greater pain reduction over time. There were no statistically significant differences in the SF-36 questionnaire, with no significant evidence regarding functional capacity, physical aspects, vitality, emotional aspects, social aspects, general health condition, and mental health. The great advantage of the patch was the degree of personal satisfaction of the patients, with statistical relevance, probably due to the easy application and psychological effect of a drug therapy. Lidocaine patches and massages are effective treatment methods for reducing scar tissue pain, with similar outcomes. The patches improved the degree of patient satisfaction.
本文旨在评估5%利多卡因贴片与手术切口部位治疗性按摩相比,在治疗骨科手术后神经性疼痛方面的应用。
这是一项前瞻性随机临床试验,研究对象为2015年1月至2017年2月期间接受骨科手术的37例患者。该研究纳入了年龄在13至70岁之间、接受足踝部骨科手术且术后手术切口部位出现神经性疼痛或超敏反应至少90天的患者。在治疗开始时以及治疗30、60和90天后,对所有患者进行疼痛评估(使用视觉模拟量表[VAS])和生活质量评估(采用SF-36问卷)。
尽管两组治疗均改善了疼痛状况,但使用利多卡因贴片的患者随着时间推移疼痛减轻程度更大。SF-36问卷结果无统计学显著差异,在功能能力、身体方面、活力、情感方面、社会方面、总体健康状况和心理健康等方面均无显著证据。贴片的一大优势在于患者的个人满意度程度,具有统计学相关性,这可能归因于药物治疗应用简便及其心理效应。
利多卡因贴片和按摩都是减轻瘢痕组织疼痛的有效治疗方法,效果相似。贴片提高了患者满意度。