Supportive Care in Cancer

, Volume 17, Issue 4, pp 451–460

Use of a lidocaine patch in the management of postsurgical neuropathic pain in patients with cancer: a phase III double-blind crossover study (N01CB)

  • Andrea L. Cheville
  • Jeff A. Sloan
  • Donald W. Northfelt
  • Anand P. Jillella
  • Gilbert Y. Wong
  • James D. Bearden III
  • Heshan Liu
  • Paul L. Schaefer
  • Benjamin T. Marchello
  • Bradley J. Christensen
  • Charles L. Loprinzi
Original Article

Abstract

Objective

Current therapies often have limited efficacy and untenable side effects when used to treat persistent incisional pain following cancer-related surgery. Lidocaine patches reduce neuropathic pain from herpes zoster but their benefits for persistent cancer-related postsurgical incisional pain remain unclear.

Study design

Multicenter, double-blind, randomized, two-period crossover trial.

Materials and methods

Twenty-eight cancer patients with postsurgical incisional pain were randomly assigned to receive either lidocaine patches followed by placebo patches or the reverse. Each study period lasted 4 weeks. Patches were applied daily upon waking and left in place for a maximum of 18 h. The primary outcome measure, an 11-point pain intensity rating scale, was administered weekly. Secondary outcomes were administered weekly (Brief Pain Inventory-Short Form(BPI-SF), Subject Global Impression of Change) and at the end of each study period (Short Form-Magill Pain Questionnaire, Linear Analogue Self Assessment Scale, Neuropathy Pain Scale, Pain Catastrophizing Scale, Profile of Mood States Short Form).

Results

Twenty-one patients completed the first period and 18 completed their crossover second phase. No significant intergroup differences were detected in pain intensity ratings. Few secondary end points were significantly different when subjects used the lidocaine versus placebo patches. BPI-SF interference scores were lower in patients using the lidocaine patch during the first study period, including several scores that achieved statistical significance, general activity (p = 0.02), work (p = 0.04), and relations with others (p = 0.02).

Conclusion

Lidocaine patch use did not significantly reduce pain intensity ratings or the majority of related secondary end points in cancer patients with persistent incisional pain.

Keywords

Lidocaine patch Postsurgical neuropathic pain Cancer Cancer-related pain 

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Andrea L. Cheville
    • 1
  • Jeff A. Sloan
    • 1
  • Donald W. Northfelt
    • 2
  • Anand P. Jillella
    • 3
  • Gilbert Y. Wong
    • 1
  • James D. Bearden III
    • 4
  • Heshan Liu
    • 1
  • Paul L. Schaefer
    • 5
  • Benjamin T. Marchello
    • 6
  • Bradley J. Christensen
    • 1
  • Charles L. Loprinzi
    • 1
    • 7
  1. 1.Mayo Clinic and Mayo FoundationRochesterUSA
  2. 2.Mayo Clinic ScottsdaleScottsdaleUSA
  3. 3.Medical College of GeorgiaAugustaUSA
  4. 4.Upstate Carolina CCOPSpartanburgUSA
  5. 5.Toledo Community Hospital Oncology Program CCOPToledoUSA
  6. 6.Montana Cancer ConsortiumBillingsUSA
  7. 7.Mayo ClinicSW RochesterUSA

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