Abstract
Purpose
To analyze the short-term efficacy and patients’ subjective perception of the use of lidocaine 5 % patches for painful scars (post-thoracotomy and post-mastectomy) and pain caused by chest wall tumors.
Methods
This is a prospective, descriptive, non-controlled, non-randomized, open-label study of patients seen in the palliative care outpatient clinic. Demographic data, variables relating to the severity of the pain, and concomitant therapy both at the start and end of treatment, the need for interventional anesthetic techniques (IAT), patients’ subjective perception and treatment-related side effects were all recorded.
Results
Twenty patients were included with a mean follow-up of 29.2 days. The treatment led to a statistically significant clinical improvement in pain severity. There was no clinically significant opioid dose escalation during the treatment period. Only three patients required IAT to relieve the pain. Sixty five percent of patients were very satisfied with the therapy. No systemic or local adverse events were reported.
Conclusions
The addition of lidocaine 5 % patches is effective in the short term for the treatment of neuropathic cancer pain accompanied by allodynia, whether deriving from a painful scar or chest wall tumor. These findings need to be confirmed by randomized controlled trials with larger samples.
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References
Garcia de Paredes ML, Moral González F, Martínez del Prado P, Martí Ciriquian JL, Enrech Francés S, Cobo Dols M et al (2011) First evidence of oncologic neuropathic pain prevalence alter screening 8615 cancer patients. Results of the On study. Ann Oncol 22:924–930
Faisinger R, Nekolaichuk C, Lawlor P, Neumann C, Hanson J, Vigano A (2005) A multicenter study of the revised edmonton staging system for classifying cancer pain in advanced cancer patients. J Pain Symptom Manage 29(3):224–236
Caraceni A, Portenoy R (1999) An international survey of cancer pain characteristics and syndromes. Pain 82:263–274
Vadauloca A, Raptis E et al (2012) Pharmacological treatment on neuropathic cancer pain: a comprehensive review of the current literature. Pain Pract 12(3):219–251
Stute P, Soukup J, Menzel M et al (2003) Analysis and treatment of different types of neuropathic cancer pain. J Pain Symptom Manage 26:1123–1131
Muguruza I, Aranda JL, García-Yuste M (2011) Tratamiento del cáncer de pulmón con invasión de la pared torácica. Arch Bronconeumol 47:27–32
Stoeben E, Ludwig C (2009) Chest wall resection for lung cancer: indications and techniques. Eur J Cardiothoracic Surg 35:450–456
Rogers ML, Duffy JP (2000) Surgical aspects of chronic post-thoracotomy pain. Eur J Cardiothorac Surg 18:711–716
Kehlet H, Jensen TS, Woolf C (2006) Persistent postsurgical pain: risk factors and prevention. Lancet 367:1618–1625
Pertunnen K, Tasmuth T, Kalso E (1999) Chronic pain after thoracic surgery: a follow up study. Acta Anaesthesiol Scand 43:563–567
Macdonald L, Bruce J, Scott NW, Smith WCS, Chambers WA (2005) Long-term follow up of breast cancer survivors with post-mastectomy pain syndrome. Br J Cancer 92:225–230
Dworkin R, O’Connor A, Audette J, Baron R, Gourlay GK, Haanpää ML et al (2010) Recommendations for the pharmacological management of neuropathic pain: an overview and literature update. Mayo Clin Proc 85:S3–S14
Meier T, Wasner G, Faust M, Kuntzer T, Ochsner F, Hueppe M et al (2003) Efficacy of lidocaine patch 5 % in the treatment of focal peripheral neurophatic pain syndromes: a randomized, double-blind, placebo-controlled study. Pain 106:151–158
Galer BS, Rowbotham MC, Perander J, Friedman E (1999) Topical lidocaine patch relieves postherpetic neuralgia more effectively than a vehicle topical patch: results of an enrichment enrollment study. Pain 80:533–538
Rowbotham MC, Davies PS, Verkempinck C, Galer BS (1996) Lidocaine patch: double-blind, controlled study of a new treatment for post-herpetic neuralgia. Pain 65:39–44
Fleming JA, O’Connor BD (2009) Use of lidocaine patches for neuropathic pain in a comprehensive cancer centre. Pain Res Manage 14:381–388
Cheville A, Sloan J, Northfelt D, Jillella A, Wong G, Bearden J et al (2009) Use of a lidocaine patch in the management of postsurgical neuropathic pain in patients with cancer: a phase III double-blind crossover study (N01CB). Support Care Canc 17:451–460
Freynhagen R, Baron R, Gockel V, Tölle TR (2006) PainDETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr Med Res Opin 22:1911–1920
Krumova E, Zeller M, Westermann A, Maier C (2012) Lidocaine patch (5 %) produces a selective, but incomplete block of Adelta and C fibers. Pain 153:273–280
Hans G, Joukes E, Verhulst J, Vercauteren M (2009) Management of neuropathic pain after surgical and non-surgical trauma with lidocaine 5 % patches: study of 40 consecutive cases. Curr Med Res Opin 25:2737–2743
Gammaitoni AR, Davis MW (2002) Pharmacokinetics and tolerability of lidocaine patch 5 % with extended doping. Ann Pharmacother 36:236–240
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This paper was presented as a poster at the MASCC/ISOO 2012. International Symposium on Supportive Care in Cancer New York City on June 28–30 2012.
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Garzón-Rodríguez, C., Casals Merchan, M., Calsina-Berna, A. et al. Lidocaine 5 % patches as an effective short-term co-analgesic in cancer pain. Preliminary results. Support Care Cancer 21, 3153–3158 (2013). https://doi.org/10.1007/s00520-013-1948-7
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DOI: https://doi.org/10.1007/s00520-013-1948-7