Topical Lidocaine

Two studies involving the transdermal lidocaine 5% patch show that it may have a role in both musculoskeletal and neuropathic pain. In one study, Hobart and Nalamachu reviewed the charts of 14 patients, all of whom had pain secondary to entrapment, tendonitis, and bursitis. Of these patients, 82% reported significant improvement over baseline symptoms, with an average improvement of 44%. This led the investigators to consider that the lidocaine patch may allow such patients to take lower doses of systemic analgesics. In the study involving neuropathic pain, Gammaitoni and colleagues pooled data from 3 open-label studies involving 286 geriatric patients with neuropathic pain. The patients reported a significant reduction in the degree to which pain interfered with sleep, and treatment was linked to a significant reduction in pain intensity and an increase in pain relief (P < .001 for all). Of these patients, 144 (50.3%) had a decrease over baseline of at least 30% in average daily pain. Most of the adverse events were local in nature, such as rash. These findings led the investigators to conclude that the patch may have particular value for elderly patients who are at increased risk of toxicity from systemic medications.

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