5%利多卡因贴膏治疗三叉神经痛的疗效、安全性及疗效预测因素：一项回顾性研究。

Effectiveness, Safety, and Predictors of Response to 5% Lidocaine-Medicated Plaster for the Treatment of Patients With Trigeminal Neuralgia: A Retrospective Study.

机构信息

Department of Day Surgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Department of Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

出版信息

Ann Pharmacother. 2023 May;57(5):527-534. doi: 10.1177/10600280221120457. Epub 2022 Aug 29.

DOI:10.1177/10600280221120457

PMID:36039508

Abstract

BACKGROUND

Whether 5% lidocaine-medicated plaster (LMP) is a valuable therapeutic option for the treatment of trigeminal neuralgia (TN) is worth exploring. If LMP is proven effective for TN, positive predictors of the analgesic effects of LMP warrant further investigation.

OBJECTIVE

To evaluate the efficacy and safety of LMP for the treatment of TN, and to explore the predictive factors for the treatment efficacy of LMP.

METHODS

This is a retrospective and observational study. We analyzed the efficacy of LMP for the treatment of TN between March 2019 and January 2022. The follow-up time was approximately 2 weeks, 1 month, 2 months, and 3 months after LMP treatment. The LMP response was considered the Barrow Neurological Institute (BNI) score of I to III and an improvement in BNI of at least I grade from pretreatment baseline. Univariable and multivariable logistic analyses were performed to identify the predictive factors for LMP response.

RESULTS

A total of 103 patients were included and analyzed in this study. LMP was effective in some TN patients, with an efficacy rate of 21.4%, 21.4%, 18.4%, and 16.5% after 2 weeks, 1 month, 2 months, and 3 months of LMP treatment, respectively. The overall adverse event rate associated with LMP was 5.8%, and the reported adverse events were all skin reactions. Facial trigger points (odds ratio [OR] = 0.25, 95% confidence interval [CI] = 0.07-0.86, = 0.03) and a lower BNI score (OR = 0.37, 95% CI = 0.07-0.87, = 0.01) were identified as potential predictors for initial efficacy (2-week follow-up) of LMP treatment.

CONCLUSIONS AND RELEVANCE

LMP has been shown to provide effective and sustained analgesia in some TN patients with minimal risk of systemic adverse reactions. Patients with facial trigger points and mild to moderate pain are more likely to benefit from LMP treatment. Our data suggest that LMP may be an effective treatment option for patients with the aforementioned characteristics of TN.

摘要

背景

5%利多卡因贴剂（LMP）是否是治疗三叉神经痛（TN）的有价值的治疗选择值得探讨。如果 LMP 被证明对 TN 有效，那么 LMP 镇痛效果的阳性预测因素值得进一步研究。

目的

评估 LMP 治疗 TN 的疗效和安全性，并探讨 LMP 治疗效果的预测因素。

方法

这是一项回顾性和观察性研究。我们分析了 2019 年 3 月至 2022 年 1 月期间 LMP 治疗 TN 的疗效。随访时间分别为 LMP 治疗后 2 周、1 个月、2 个月和 3 个月。LMP 反应被认为是巴罗神经研究所（BNI）评分 I 至 III 级，并且与治疗前基线相比 BNI 至少改善 I 级。进行单变量和多变量逻辑分析以确定 LMP 反应的预测因素。

结果

共有 103 例患者纳入本研究并进行分析。LMP 对一些 TN 患者有效，在 LMP 治疗后 2 周、1 个月、2 个月和 3 个月时的有效率分别为 21.4%、21.4%、18.4%和 16.5%。与 LMP 相关的总体不良事件发生率为 5.8%，报告的不良事件均为皮肤反应。面部触发点（比值比 [OR] = 0.25，95%置信区间 [CI] = 0.07-0.86， = 0.03）和较低的 BNI 评分（OR = 0.37，95%CI = 0.07-0.87， = 0.01）被确定为 LMP 治疗初始疗效（2 周随访）的潜在预测因素。