Topical lidocaine patch relieves a variety of neuropathic pain conditions:An open-label study

Objective: Our goal was to perform a pilot study to assess the effectivenes s and tolerability of a topical lidocaine patch (Lidoderm) for the treatmen t of peripheral neuropathic pain conditions other than postherpetic neuralg ia. Design: This was an open-label prospective study. Patients: Sixteen patients with refractory peripheral neuropathic pain cond itions who had reported intolerable side effects or inadequate pain relief with antidepressant, anticonvulsant, antiarrhythmic, and opioid medications participated in this study. Diagnoses included postthoracotomy pain, stump neuroma pain, intercostal neuralgia, diabetic polyneuropathy, meralgia par esthetica, complex regional pain syndrome, radiculopathy, and postmastectom y pain. Outcome Measures: A six-item Pain Relief Scale was used (0 = worse pain, 1 = no change, 2 = slight relief, 3 = moderate relief, 4 = a lot of relief, 5 = complete relief). Results: Moderate or better pain relief was reported by 13 of the 16 partic ipants (81%). One patient stopped treatment after 4 days due to lack of rel ief. The remaining 15 patients had a mean duration of patch use of 6.2 week s with continued relief. Only 1 patient reported a side effect, a mild skin irritation. Conclusions: The Lidoderm parch provided clinically meaningful pain relief in most of these refractory neuropathic pain patients without side effects. Controlled trials need to be performed to confirm these preliminary findin gs.