Adjuvant analgesics in neuropathic pain

Kong, Vincent KF; Irwin, Michael G

European Journal of Anaesthesiology: February 2009 - Volume 26 - Issue 2 - p 96–100
doi: 10.1097/EJA.0b013e328318c706
Review

Conventional analgesics have limited efficacy in the management of neuropathic pain. An adjuvant analgesic is a drug that has a primary nonpain indication but which may be analgesic in certain circumstances, and many of these have established a role in the pharmacological treatment of neuropathic pain. The number needed to treat is an indirect statistical measure that can be used to compare relative efficacy of different adjuvant analgesics and, from this, there is currently insufficient evidence to suggest that any one adjuvant analgesic has absolute advantages over another. Analgesic efficacy, tolerability, safety/toxicity, drug interactions, ease of use, and cost-effectiveness are essential factors that guide the selection of an adjuvant analgesic. Cost-effectiveness data are absent for the vast majority of these drugs. Pharmacological treatments should be used as part of a multimodal therapeutic programme for the management of neuropathic pain.

Department of Anaesthesiology, The University of Hong Kong, Queen Mary Hospital, Hong Kong

Received 11 March, 2008

Revised 28 April, 2008

Accepted 10 June, 2008

Correspondence to Michael G. Irwin, Associate Professor and Head, Department of Anaesthesiology, The University of Hong Kong, Queen Mary Hospital, Hong Kong Tel: +852 28555791; fax: +852 28553384; e-mail: mgirwin@hkucc.hku.hk

© 2009 European Society of Anaesthesiology