Medicated Plaster Well Tolerated as Localized Neuropathic Pain Treatment

Neuropathic pain is well tolerated when treated with 5 percent lidocaine medicated plaster, according to research published in the International Journal of General Medicine.

Researchers from the Hospital Klagenfurt in Klagenfurt, Austria retrospectively analyzed 27 patients with neuropathic pain who were treated with topical 5 percent lidocaine in order to evaluate the efficacy and safety of the medicated plaster treatment in localized neuropathic pain scenarios. There were 17 female and 10 male patients with an average age of 53 years who were treated with the medication mainly for dorsalgia (16 patients) — which comprised diagnoses for cervical, thoracic, and/ or lumbar spine syndrome, neck, thoracic spine, and lower back pain – or post operative and/ or post traumatic pain (7patients). There was 1 patient included in the analysis who suffered from both ailments.

Patients suffered from the pain for an average duration of 3 years. Nearly all of the patients (92.6 percent) suffered from neuralgiform pain, from burning pain (63.0 percent); 6 patients had allodynia, and 8 patients experienced hyperalgesia.

Most of the patients (85.2 percent) used one plaster per day for a 12-hour period, although one applied half a plaster, 2 administered 2 plasters per day to the painful area, and 1 patient’s requirements varied from 0.5 and 1 daily plaster. The plaster was applied concomitantly with preexisting pain medication in most patients (81.5 percent), while 1 patient received the plaster as monotherapy and 4 patients were permitted to use other analgesics if needed. The concomitant drugs included non steroidal anti inflammatory drugs, opioids, other analgesics, gabapentinoids, benzodiazepines, muscle relaxants, methylprednisolone, esketamine hydrochloride, mexiletine hydrochloride, and orphenadrine. Not all patients finished the study — 2 discontinued treatment after 4 months, and another after 5 months.

The researchers reviewed the patients’ records for overall pain intensity, the intensity of different pain qualities, and changes in sleep quality. Prior to lidocaine medicated plaster treatment, the overall pain intensity scored an average of 8.4 out of 11 on the Likert scale (0 = pain not present ranging to 10 = worse possible state). After the 6 month observation period, pain intensity was reduced overall by nearly 5 points to 3.5 on the Likert scale.

Other changes were also reported in pain: neuralgiform pain was reduced by 5 points from 7.9 points at baseline; burning pain was reduced by 3 points from the baseline measurement of 5.2; sleep quality improved in patients from 4.6 at baseline to 5.5 after the observation period.

“The observed benefits suggest a topical therapy, such as the 5 percent lidocaine medicated plaster, as a useful medication and simple solution, in particular owing to the proven efficacy in combination with very low systemic lidocaine absorption and thus low risk of systemic adverse events and of drug—drug interactions with concomitant medications,” the authors concluded.