This medicine should only be used on the skin. Use this medicine exactly as directed by your doctor. If you are using this medicine for the throat, gargle the undiluted solution. If you are using this medicine in the mouth, swish the solution around inside the mouth and spit it out. Use an accurate measuring device to avoid using more than the prescribed amount of medicine. If you are using the viscous topical solution: If any of the medicine does get into the eyes, wash the eyes with water for at least 15 minutes and check with your doctor right away. Unless otherwise directed by your doctor, do not apply this medicine to open wounds, burns, or broken or inflamed skin.īe careful not to get any of the ointment in your eyes, because it can cause severe eye irritation. Wash your hands with soap and water before and after using this medicine. If you are using the topical jelly or ointment:Ī nurse or other trained health care professional may give you this medicine before having a medical procedure. Ask your doctor if you have any questions. Read and follow these instructions carefully. This medicine should come with a patient information and instructions leaflet. This medicine should not be used to treat certain kinds of skin infections or serious problems, such as severe burns. Check with your doctor before using it for other problems, especially if you think that an infection may be present. Pooling multiple-dose studies across conditions demonstrated no clear evidence of an effect of lidocaine on the incidence of adverse events or withdrawals, but there were few events and the withdrawal phase of enriched enrolment designs is not suitable to assess the true impact of adverse events (very low quality evidence).This medicine should only be used for problems being treated by your doctor. In all but one study, third tier (very low quality) evidence indicated that lidocaine was better than placebo for some measure of pain relief. The two enriched enrolment, randomised withdrawal studies reported time to loss of efficacy. Three single-dose studies reported participants who were pain-free at a particular time point, or had a 2-point (of 10) reduction in pain intensity. Only one multiple-dose study reported our primary outcome of participants with ≥ 50% or ≥ 30% pain intensity reduction. There was no first or second tier evidence, and no pooling of data was possible for efficacy outcomes. We judged all of the studies at high risk of bias because of small size or incomplete outcome assessment, or both. Seven studies used multiple doses, with one to four-week treatment periods, and five used single applications. Two studies used enriched enrolment with randomised withdrawal. Most studies used a cross-over design, and two used a parallel-group design. Four different formulations were used: 5% medicated patch, 5% cream, 5% gel, and 8% spray. Six studies enrolled participants with moderate or severe postherpetic neuralgia, and the remaining studies enrolled different, or mixed, neuropathic pain conditions, including trigeminal neuralgia and postsurgical or post-traumatic neuralgia. We included 12 studies (508 participants) in comparisons with placebo or an active control. They will be of great help in working out the benefits of topical lidocaine when they are completed and results can be incorporated in this review. There was no clear evidence of an effect of lidocaine on the incidence of adverse events or withdrawals (very low quality evidence).Ī number of studies of topical lidocaine in neuropathic pain are ongoing. There was some indication that topical lidocaine was beneficial in these studies (very low quality evidence). The 508 people in the studies had different types of neuropathic pain, with pain after herpes zoster infection the most common. One study also tested a cream containing amitriptyline, which is an antidepressant. We found 12 small studies of modest quality that tested topical lidocaine against topical placebo for a number of weeks. In July 2014 we performed searches to look for clinical trials where topical lidocaine was used to treat neuropathic pain. Treatment with plasters usually involves applying one, two, or three plasters for up to 12 hours a day. These contain high concentrations of lidocaine because it crosses the skin poorly. It is available in plasters (or patches), sprays, and creams, as topical lidocaine. Other possible treatments include the use of local anaesthetic applied to the skin. Medicines like paracetamol or ibuprofen are usually not effective in neuropathic pain, while medicines that are sometimes used to treat epilepsy or depression can be very effective in some people with neuropathic pain. Neuropathic pain is treated by different medicines than pain from damaged tissue. It differs from pain messages carried along healthy nerves from damaged tissue (a fall, or cut, or arthritic knee). Neuropathic pain is pain coming from damaged nerves.
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