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      Tratamiento de cicatrices dolorosas con parche de lidocaína al 5 %: reporte de casos clínicos Translated title: Treatment of painful scars with 5 % lidocaine patch: clinical cases report

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          Abstract

          RESUMEN Las cicatrices pueden asociarse a dolor de gran intensidad, limitar la funcionalidad y afectar la calidad de vida de los pacientes. Además, las cicatrices dolorosas pueden asociarse a disestesias, hiperalgesia y alodinia. El parche de lidocaína al 5 % ha demostrado eficacia como tratamiento tópico para el alivio del dolor en cicatrices traumáticas o postquirúrgicas. En el presente trabajo se describen tres casos de pacientes con cicatrices dolorosas que fueron tratados exitosamente mediante parches de lidocaína al 5 %, una herramienta terapéutica indicada frecuentemente para el alivio del dolor neuropático.

          Translated abstract

          ABSTRACT Scars can be associated with intense pain, limit patient functionality, and affect the quality of life of patients. In addition, painful scars can be associated to dysesthesias, hyperalgesia, and allodynia. The 5% lidocaine patch has shown efficacy as a topical treatment for pain relief in traumatic or post-surgical scars. In this paper, three cases of patients with painful scars who were successfully treated with 5% lidocaine patches, a therapeutic tool frequently indicated for the relief of neuropathic pain, are described.

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          Persistent postsurgical pain: risk factors and prevention.

          Henrik Kehlet, Troels Jensen, Clifford Woolf (2006)
          Acute postoperative pain is followed by persistent pain in 10-50% of individuals after common operations, such as groin hernia repair, breast and thoracic surgery, leg amputation, and coronary artery bypass surgery. Since chronic pain can be severe in about 2-10% of these patients, persistent postsurgical pain represents a major, largely unrecognised clinical problem. Iatrogenic neuropathic pain is probably the most important cause of long-term postsurgical pain. Consequently, surgical techniques that avoid nerve damage should be applied whenever possible. Also, the effect of aggressive, early therapy for postoperative pain should be investigated, since the intensity of acute postoperative pain correlates with the risk of developing a persistent pain state. Finally, the role of genetic factors should be studied, since only a proportion of patients with intraoperative nerve damage develop chronic pain. Based on information about the molecular mechanisms that affect changes to the peripheral and central nervous system in neuropathic pain, several opportunities exist for multimodal pharmacological intervention. Here, we outline strategies for identification of patients at risk and for prevention and possible treatment of this important entity of chronic pain.
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            Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4).

            Patrick Ginies, Nadine Attal, Eric Vicaut … (2005)
            Few studies have directly compared the clinical features of neuropathic and non-neuropathic pains. For this purpose, the French Neuropathic Pain Group developed a clinician-administered questionnaire named DN4 consisting of both sensory descriptors and signs related to bedside sensory examination. This questionnaire was used in a prospective study of 160 patients presenting with pain associated with a definite neurological or somatic lesion. The most common aetiologies of nervous lesions (n=89) were traumatic nerve injury, post herpetic neuralgia and post stroke pain. Non-neurological lesions (n=71) were represented by osteoarthritis, inflammatory arthropathies and mechanical low back pain. Each patient was seen independently by two experts in order to confirm the diagnosis of neuropathic or non-neuropathic pain. The prevalence of pain descriptors and sensory dysfunctions were systematically compared in the two groups of patients. The analysis of the psychometric properties of the DN4 questionnaire included: face validity, inter-rater reliability, factor analysis and logistic regression to identify the discriminant properties of items or combinations of items for the diagnosis of neuropathic pain. We found that a relatively small number of items are sufficient to discriminate neuropathic pain. The 10-item questionnaire developed in the present study constitutes a new diagnostic instrument, which might be helpful both in clinical research and daily practice.
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              The IASP classification of chronic pain for ICD-11: chronic postsurgical or posttraumatic pain

              Stephan Schug, Patricia Lavandʼhomme, Antonia Barke … (2019)
              Chronic pain after tissue trauma is frequent and may have a lasting impact on the functioning and quality of life of the affected person. Despite this, chronic postsurgical and posttraumatic pain is underrecognised and, consequently, undertreated. It is not represented in the current International Classification of Diseases (ICD-10). This article describes the new classification of chronic postsurgical and posttraumatic pain for ICD-11. Chronic postsurgical or posttraumatic pain is defined as chronic pain that develops or increases in intensity after a surgical procedure or a tissue injury and persists beyond the healing process, ie, at least 3 months after the surgery or tissue trauma. In the classification, it is distinguished between tissue trauma arising from a controlled procedure in the delivery of health care (surgery) and forms of uncontrolled accidental damage (other traumas). In both sections, the most frequent conditions are included. This provides diagnostic codes for chronic pain conditions that persist after the initial tissue trauma has healed and that require specific treatment and management. It is expected that the representation of chronic postsurgical and posttraumatic pain in ICD-11 furthers identification, diagnosis, and treatment of these pain states. Even more importantly, it will make the diagnosis of chronic posttraumatic or postsurgical pain statistically visible and, it is hoped, stimulate research into these pain syndromes.
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                Author and article information

                Journal
                Journal ID (publisher-id): dolor
                Title: Revista de la Sociedad Española del Dolor
                Abbreviated Title: Rev. Soc. Esp. Dolor
                Publisher: Inspira Network Group, S.L (Madrid, Madrid, Spain )
                ISSN (Print): 1134-8046
                Publication date (Print and electronic): June 2022
                Volume: 29
                Issue: 3
                Pages: 187-191
                Affiliations
                [1] Santiago orgnameClínica RedSalud Providencia Chile
                [2] Santiago Santiago de Chile orgnameUniversidad Mayor Chile
                Article
                Publisher ID: S1134-80462022000400010 Publisher ID: S1134-8046(22)02900300010
                DOI: 10.20986/resed.2022.3997/2022
                SO-VID: 2acbd748-3684-4db8-9266-b8cd91826875
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                Date accepted : 26 September 2022
                Date received : 02 June 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 29, Pages: 5
                Product

                SciELO Spain

                Categories
                Subject: Nota Clínica

                Keywords: 5 % lidocaine,parches,lidocaína 5 %,dolor neuropático,Cicatrices dolorosas,patches,neuropathic pain,Painful scars
                Data availability:
                Keywords: 5 % lidocaine, parches, lidocaína 5 %, dolor neuropático, Cicatrices dolorosas, patches, neuropathic pain, Painful scars

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