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Minerva Medica 2014 June;105(3):177-95


language: Italian

Localized neuropathic pain - 5% lidocaine medicated plaster as a first line treatment and as add-on therapy: literature review and personal experience

Casale R. 1, 2, Polati E. 3, Schweiger V. 3, Coluzzi F. 4, Bhaskar A. 2, Mattia C. 4

1 Servizio Neurofisiopatologia, Unità di Diagnosi e Riabilitazione del Dolore, Istituto Scientifico di Montescano, IRCCS Fondazione “S. Maugeri”, 27040 ‑ Montescano (PV); 2 Montescano Pain School, 27040 Montescano, Italy; 3 Sezione di Anestesiologia, Rianimazione e Terapia Antalgica, Policlinico ”G.B. Rossi” Ospedale Borgo Roma, Verona; 4 Dipartimento di Biotecnologie e Scienze Medico‑Chirurgiche, Sezione di Anestesia, Rianimazione e Medicina del Dolore, Facoltà di Medicina e Farmacia, Sapienza Università di Roma


Localized neuropathic pain (LNP) is a type of neuropathic pain characterized by consistent and circumscribed area(s) of maximum pain, which are associated with negative or positive sensory signs and/or spontaneous symptoms typical of neuropathic pain. This description outlines the clinical features of a group of pathologies, in which a LNP can be diagnosed and for whom topical targeted treatment with 5% Lidocaine medicated plaster can be suggested. Indeed both American as well as European guidelines already suggest 5% Lidocaine medicated plaster as a first line treatment in post herpetic neuralgia and in general in the treatment of conditions such as diabetic painful polyneuropathy and post surgical pain where a LNP can be ascertain. In a daily practice of a Pain Unit however the usual case mix encompasses also other causes of LNP, most of them with a scanty pain control in spite of a ongoing polytherapy. Aims of this paper were to focus on 5% Lidocaine medicated plaster as a first line treatment in LNP and to add new insight on its possible use as add-on therapy reporting our data on a consecutive series of 42 patients affected by LNP under unsatisfactory polytherapy in which 5% Lidocaine medicated plaster was able to achieve a satisfactory pain control.

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