Rowbotham Michael C, Davies Pamela S, Verkempinck Christina, Galer Bradley S
Departments of Neurology and Anesthesia, UCSF Pain Clinical Research Center, University of California, San Francisco, CA 94115 USA.
Pain. 1996 Apr;65(1):39-44. doi: 10.1016/0304-3959(95)00146-8.
Post-herpetic neuralgia (PHN) is a common and often intractable neuropathic pain syndrome predominantly affecting the elderly. Topical local anesthetics have shown promise in both uncontrolled and controlled studies. Thirty-five subjects with established PHN affecting the torso or extremities completed a four-session, random order, double-blind, vehicle-controlled study of the analgesic effects of topically applied 5% lidocaine in the form of a non-woven polyethylene adhesive patch. All subjects had allodynia on examination. Up to 3 patches, covering a maximum of 420 cm2, were applied to cover the area of greatest pain as fully as possible. Lidocaine containing patches were applied in two of the four 12-h-long sessions, in one session vehicle patches were applied, and one session was a no-treatment observation session. Lidocaine containing patches significantly reduced pain intensity at all time points 30 min to 12 h compared to no-treatment observation, and at all time points 4--12 h compared to vehicle patches. Lidocaine patches were superior to both no-treatment observation and vehicle patches in averaged category pain relief scores. The highest blood lidocaine level measured was 0.1 micrograms/ml, indicating minimal systemic absorption of lidocaine. Patch application was without systemic side effect and well tolerated when applied on allodynic skin for 12 h. This study demonstrates that topical 5% lidocaine in patch form is easy to use and relieves post-herpetic neuralgia.
带状疱疹后神经痛（PHN）是一种常见且往往难以治疗的神经性疼痛综合征，主要影响老年人。在非对照和对照研究中，局部用局部麻醉药均显示出了前景。35例已确诊的躯干或四肢PHN患者完成了一项四阶段、随机顺序、双盲、赋形剂对照研究，该研究采用非织造聚乙烯贴剂形式的5%利多卡因局部应用的镇痛效果。所有受试者检查时均有痛觉过敏。最多可应用3片贴剂，最大覆盖面积为420平方厘米，尽可能完全覆盖最疼痛区域。含利多卡因的贴剂在四个12小时疗程中的两个疗程应用，一个疗程应用赋形剂贴剂，一个疗程为无治疗观察期。与无治疗观察相比，含利多卡因的贴剂在30分钟至12小时的所有时间点均显著降低疼痛强度；与赋形剂贴剂相比，在4至12小时的所有时间点均显著降低疼痛强度。利多卡因贴剂在平均疼痛缓解类别评分方面优于无治疗观察和赋形剂贴剂。测得的最高血利多卡因水平为0.1微克/毫升，表明利多卡因的全身吸收极少。贴剂应用无全身副作用，在痛觉过敏皮肤上应用12小时时耐受性良好。本研究表明，贴剂形式的局部用5%利多卡因易于使用且可缓解带状疱疹后神经痛。
