Treatment of Neuropathic Pain: An Overview of Recent Guidelines

摘要: Abstract A number of different treatments for neuropathic pain have been studied, but the literature is sizable, rapidly evolving, and lacks important information about practical aspects patient management. Under auspices International Association Study Pain (IASP) Neuropathic Special Interest Group (NeuPSIG), a consensus process was used to develop evidence-based guidelines pharmacologic management that take into account clinical efficacy, adverse effects, impact on health-related quality life, convenience, costs. On basis randomized trials, medications recommended as first-line included certain antidepressants (i.e., tricyclic dual reuptake inhibitors both serotonin norepinephrine), calcium channel α 2 -δ ligands gabapentin pregabalin), topical lidocaine. Opioid analgesics tramadol were second-line can be considered use in selected circumstances. Other generally would third-line include other antidepressant antiepileptic medications, capsaicin, mexiletine, N -methyl-d-aspartate receptor antagonists. Two national international associations recently published treatment pain, which are summarized contrasted with NeuPSIG recommendations. Recent neurostimulation also summarized. For all long-term studies, head-to-head comparisons, studies combinations priority future research.