Transdermal Lidocaine and Ketamine for Neuropathic Pain: A Study of Effectiveness and Tolerability



Emily Tam, Andrea D Furlan*
Toronto Rehabilitation Institute, (University Health Network) 550 University Av, room 12-020, Toronto, ON, M5G 2A2, Canada


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© Tam and Furlan; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Toronto Rehabilitation Insti-tute, 550 University Av, room 12-020, Toronto, ON, M5G 2A2, Canada; Tel: 416 597 3422; Ext: 4607; Fax: 4165166373; E-mail: Andrea.Furlan@uhn.ca


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.