The development of a lidocaine 5% patch (Lidoderm®; Endo Laboratories; Chadds Ford, PA) has facilitated the topical application of local anesthetics. This formulation is approved in the U.S. for the treatment of postherpetic neuralgia; however, there are a variety of case reports and small studies of its use in cancer syndromes. Clinical experience supports its use for other neuropathic pain conditions. There are a number of phase II studies that include patients with neuropathic pain related to either cancer or cancer therapy
Considering that the Lidoderm patch is fairly new and the kind an amount of evidence available and that there appear to be two phase II studies, I consider Lidoderm to be supported for local cancer pain syndromes. In addition, NCCN in its Adult Pain recommendation lists Lidoderm as an adjuvant treatment.
I.Wilhelm, N.Griessinger, W.Koppert, R.Sittl, R.LikarHigh Doses of Topically Applied Lidocaine in a Cancer Patient Journal of Pain and Symptom Management, Volume 30, Issue 3, Pages 203-204
Anjum SKJ, Jyoti B, Charu M. (2002) Intravenous lidocaine infusion for neuropathic pain in cancer patients—a preliminary study. Indian J naesth 46:360–364.
Devers A and Galer BS. (2000) Topical lidocaine patch relieves a variety of neuropathic pain conditions: an open-label study. Clin J Pain 16:205–8.
Meier T, Wasner G, Faust M, et al.: Efficacy of lidocaine patch 5% in the treatment of focal peripheral neuropathic pain syndromes: a randomized, double-blind, placebo-controlled study. Pain 106 (1-2): 151-8, 2003.
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