Chapter

Local anaesthetics and other pharmacological approaches

Gary McCleane

in Neuropathic Pain

Second edition

Published on behalf of Oxford University Press

ISBN: 9780199563678
Published online May 2011 | e-ISBN: 9780199607426 | DOI: http://dx.doi.org/10.1093/med/9780199563678.003.0012

Series: Oxford Pain Management Library

Local anaesthetics and other pharmacological approaches

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• While antidepressants, antiepileptics, and opioids form the mainstay of neuropathic pain management, alternative approaches are needed because not all patients respond to these drugs and side-effects can limit their use in others • Topically applied drugs such a lidocaine 5% patches and capsaicin cream can produce local analgesic effects, though lidocaine is better tolerated • Baclofen and tizanidine are conventionally used as skeletal muscle relaxants but can be effective neuropathic pain agents • The analgesic effects of cannabinoids have not been as significant as were initially expected • Intravenous fosphenytoin and lidocaine are useful adjuncts for reducing acute flare-ups of neuropathic pain.

While the conventional pharmacological treatment of neuropathic pain revolves around the use of the opioid analgesics, tricyclic antidepressants, and antiepileptic drugs, a variety of other pharmacological entities outside these groups are used successfully in some patients with neuropathic pain.

Chapter.  2703 words. 

Subjects: Anaesthetics ; Pain Medicine

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