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Long-term treatment of neuropathic pain with a 5% lidocaine medicated plaster

Wilhelm, Ilca Ricardaa; Tzabazis, Alexandera; Likar, Rudolfb; Sittl, Reinharda; Griessinger, Norberta

European Journal of Anaesthesiology: February 2010 - Volume 27 - Issue 2 - p 169–173
doi: 10.1097/EJA.0b013e328330e989
Chronic pain

Background and objective: The 5% lidocaine medicated plaster is a topical treatment for peripheral neuropathic pain symptoms (e.g. burning, shooting and stabbing pain) and is registered for the treatment of postherpetic neuralgia. This study examined the efficacy and tolerability of long-term treatment with the 5% lidocaine medicated plaster in patients with localized neuropathic pain conditions.

Methods: Twenty patients with localized neuropathic pain [postoperative neuropathic pain (n = 14); complex regional pain syndrome (n = 2); and postherpetic neuralgia (n = 4)], who had been successfully treated with 5% lidocaine medicated plaster, were followed up by telephone interview after 3 and 5 years. Questions were related to the efficacy, development of tolerance, tolerability, wear time and comfort of the plaster.

Results: At 3 years, 10 out of 20 (50%) initial responders were still using the plasters with no decline in analgesic efficacy. After 5 years, eight of the original 20 responders (40%) maintained treatment and continued to experience effective pain relief. The 12 responders who discontinued treatment did so because they no longer required analgesic therapy (n = 4); their health insurer refused to fund treatment (n = 2); they were lost to follow-up (n = 1); or had died from an illness unrelated to plaster treatment (n = 5). No patient discontinued because of inadequate analgesia or intolerable side effects. Reversible erythema occurred in two patients wearing the plaster for more than 16 h. There were no systemic side effects.

Conclusion: The 5% lidocaine medicated plaster provides sustained pain relief over long-term treatment in patients with neuropathic pain of various causes and is well tolerated.

aDepartment of Anaesthesiology, University Hospital Erlangen, Erlangen, Germany

bDepartment of Anaesthesiology and Intensive Care, Landeskrankenhaus Klagenfurt, Klagenfurt, Austria

Received 19 January, 2009

Revised 6 July, 2009

Accepted 13 July, 2009

Correspondence to Dr med Ilca Ricarda Wilhelm, Department of Anaesthesiology, University Hospital Erlangen, Krankenhausstr.12, 91054 Erlangen, Germany Tel: +49 9131 8532558; fax: +49 9131 8532546; e-mail: ilca.wilhelm@kfa.imed.uni-erlangen.de

© 2010 European Society of Anaesthesiology