ORIGINAL ARTICLE   

Minerva Medica 2018 October;109(5):344-51

DOI: 10.23736/S0026-4806.18.05690-2

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Efficacy of lidocaine 5% medicated plaster (VERSATIS®) in patients with localized neuropathic pain poorly responsive to pharmacological therapy

Alvise MARTINI ¹ ✉, Giovanna DEL BALZO ², Vittorio SCHWEIGER ¹, Michele ZANZOTTI ¹, Alessandro PICELLI ³, Massimo PAROLINI ¹, Eris CHINELLATO ⁴, Stefano TAMBURIN ⁵, Enrico POLATI ¹

¹ Department of Surgery, Dentistry, Maternal and Infant Sciences, Pain Therapy Center, Verona University Hospital, Policlinico GB Rossi, Verona, Italy; ² Section of Forensic Medicine, Department of Medicine and Public Health, Verona University Hospital, Policlinico GB Rossi, Verona, Italy; ³ Department of Neurosciences, Biomedicine and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, Verona University Hospital, Policlinico GB Rossi, Verona, Italy; ⁴ School of Science and Engineering, Middlesex University, London, UK; ⁵ Department of Neurosciences, Biomedicine, and Movement Sciences, Verona University Hospital, Policlinico GB Rossi, Verona, Italy

BACKGROUND: Localized neuropathic pain (LNP) is a subgroup of neuropathic pain characterized by consistent and circumscribed area(s) of maximum pain, associated with negative or positive sensory signs and/or spontaneous symptoms characteristic of NP. Lidocaine medicated plasters (LMP) have shown to be effective in pain relief in selective LNP syndromes.
METHODS: We collected data of 130 patients in our database with LNP syndromes who used LMP.
RESULTS: Forty-one patients out of 130 patients (32%) were treated with antiepileptics, antidepressants and opioids without improvement and/or with intolerable adverse effects and are not assuming systemic therapy anymore. Globally, during the 12 months follow-up, 15% of patients reached a complete pain relief without any systemic therapy, mainly in trigeminal and post-herpetic neuralgia (P=0.009), 38% of patients reduced analgesic drug consumption with the highest reduction in radiculopathy, post-herpetic neuralgia and trigeminal neuralgia. Topical and transient adverse effects, such as itching or local erythema, were seen in 19/130 (14.6%) patients; 7 of these patients (5.4%) needed to discontinue the treatment due to the occurrence of adverse effects. The dropout rate on global population (excluding cured and lost to follow-up) was 45%, and the main cause of dropouts was the inefficacy of treatment in the first 3 months of therapy with LMP.
CONCLUSIONS: LMP treatment is safe and worth consideration also as add-on therapy in order to reduce analgesic drug consumption in selected LNP.

KEY WORDS: Low back pain - Cicatrix - Radiculopathy - Trigeminal neuralgia - Failed back surgery syndrome