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Open Neurol J. 2012;6:58-64. doi: 10.2174/1874205X01206010058. Epub 2012 Jun 28.

Transdermal lidocaine and ketamine for neuropathic pain: a study of effectiveness and tolerability.

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1
Toronto Rehabilitation Institute, (University Health Network) 550 University Av, room 12-020, Toronto, ON, M5G 2A2, Canada.

Abstract

BACKGROUND:

Acute neuropathic pain is a common disorder. Transdermal cream could be an alternative to oral medications.

OBJECTIVE:

To evaluate the effectiveness and tolerability of transdermal Lidocaine and Ketamine for acute neuropathic pain.

STUDY DESIGN:

Retrospective chart review

SETTING:

University-affiliated outpatient Physiatry clinic

METHODS:

ARTICIPANTS: neuropathic pain with a prescription of a transdermal cream containing Lidocaine and Ketamine. Ef-fectiveness was evaluated by the number of patients with improvement divided by the total number of patients who re-ceived a prescription of the cream.

RESULTS:

A total of 854 patient charts were reviewed. Twenty-one patients with symptoms, signs, and/or a documented di-agnosis of neuropathic pain and had been given a prescription of a transdermal preparation containing Lidocaine and Ketamine. Four groups were identified: those with a clearly stated diagnosis of neuropathic pain and prescribed a transdermal compound containing Lidocaine and Ketamine with follow-up (Group A) or without follow-up (Group B), and those with a suggested diagnosis of neuropathic pain with (Group C) or without follow-up (Group D). Effectiveness of the cream was seven out of eight (87%) for Group A and one out of three (33%) for Group C. In total, eight out of 11 patients (73%) benefited from a cream containing Lidocaine and Ketamine. Two patients experienced skin reactions that led to discontin-uation of treatment.

LIMITATIONS:

This is a retrospective chart review without control group.

CONCLUSION:

Transdermal cream containing Ketamine and Lidocaine was effective in 73% of patients with acute neuro-pathic pain and may be a good alternative to oral medications.

KEYWORDS:

Transdermal; ketamine; lidocaine; neuropathic pain.

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