ReviewTopical Analgesics in the Management of Acute and Chronic Pain
Section snippets
Methods
A MEDLINE/PubMed search, covering the period from inception through August 2011, was conducted using the keywords topical analgesic AND chronic pain OR acute pain OR neuropathic pain. The keyword postoperative pain was not included in the search, which largely restricted the search to acute pain conditions other than postoperative pain. In addition, the search was restricted to English-language articles describing individual clinical trials (not reviews of published clinical trials) in humans
Study Identification
The literature search identified a total of 92 articles, of which 65 were eligible for inclusion (Figure).29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88, 89, 90, 91, 92 A total of 27 articles were excluded: 7 articles93, 94, 95, 96, 97, 98, 99 described studies in which the analgesic was not administered
Discussion
Topical formulations of a variety of analgesics have been studied for the treatment of diverse indications (Supplemental Table). However, many of the published studies were small, and studies involving patients with chronic pain were often of short duration. NSAIDs are among the most commonly prescribed drugs throughout the world,124 and hence, it is not surprising that topical formulations of these agents have been studied more widely than topical formulations of other agents. The available
Conclusion
Topical analgesic therapy using NSAIDs or lidocaine has an important place in the management of acute and chronic pain conditions and warrants further study.
Acknowledgments
Technical editorial and medical writing support for the preparation of this article was provided by Karamarie Fecho, PhD, and Synchrony Medical, LLC, West Chester, Pennsylvania.
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Grant Support: Funding for this study was provided by Mallinckrodt Inc, a Covidien company, Hazelwood, Missouri.
Potential Competing Interests: Dr Argoff discloses the following relationships: Boehringer Ingelheim GmbH (consultant); Covidien (consultant); Depomed Inc (consultant, speakers bureau); Eli Lilly and Company (grant/research, consultant, speakers bureau); Endo Pharmaceuticals (grant/research, consultant, speakers bureau, investigator); Forest Laboratories Inc (grant/research, consultant, speakers bureau, investigator); Gruenenthal (consultant); Jazz Pharmaceuticals plc (consultant); King Pharmaceuticals Inc (consultant); NeurogesX Inc (grant/research, consultant, speakers bureau, investigator); Nuvo Research Inc (consultant); Pfizer Inc (grant/research, consultant, speakers bureau, investigator); PriCara Division of Ortho-McNeil-Janssen Pharmaceuticals Inc (consultant, speakers bureau); Shinoghi Pharmaceuticals (consultant); and Sanofi US (consultant).