Management of neuropathic pain after surgical and non-surgical trauma with lidocaine 5% patches: study of 40 consecutive cases.

Objective: To determine the efficacy of lidocaine 5% patches [Versatis, commercialised by Grünenthal GmbH, Aachen, Germany] in patients with PNCCP.

Background: This study focuses on chronic pain states of a neuropathic nature, located at the scar or over a larger area of the skin around the scar. This post-operative/post-traumatic neuropathic chronic cutaneous pain (PNCCP) may be a side-effect of any incision of the skin in the context of a surgical procedure or a traumatic event.

Research Design And Methods: A single-centre, open, non-randomised, prospective study was performed in a university hospital referral centre for patients with chronic neuropathic pain after surgical or non-surgical trauma. Forty consecutive patients with chronic PNCCP, a VAS score > or =5, a LANSS score > or =12, and a stable consumption of pain medication were prospectively evaluated. All patients were given lidocaine 5% patches, following a 12 h on/off schedule.

Main Outcome Measures: Visual analogue scale (VAS) and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scorings were performed pretreatment (day 0), on the 28th day (4 weeks), and after 84 days (12 weeks).

Results: The mean pretreatment VAS score (VAS(0)) was 7.225 +/- 1.209, and the mean pretreatment LANSS score (LANSS(0)) was 18.60 +/- 2.610. The number of patients with a VAS score <5 at the latest follow-up (VAS(84)) was 21 (52.5%). Mean VAS(84) was 4.625 +/- 1.675. Seventeen patients (42.5%) had a LANSS score <12 at the latest follow-up. Overall mean LANSS(84) was 12.85 +/- 3.093.

Conclusion: Lidocaine 5% patches seem to be an effective treatment of post-surgical and post-traumatic pain. These results should be supported with randomised and placebo-controlled studies with larger sample sizes and longer follow-ups.