Acute neuropathic pain: diagnosis and treatment.
Curr Opin Anaesthesiol. 2008 Oct;21(5):590-5
Authors: Gray P
PURPOSE OF REVIEW: Acute neuropathic pain (ANP) is a condition that is under-recognized, often difficult to treat and one that may progress to persistent pain and disability. This review examines the diagnosis and treatment in order to assist clinicians in providing better care to patients with this debilitating pain. RECENT FINDINGS: The recent development of psychometric scales for the detection of neuropathic pain may assist in diagnosing ANP, though this is yet to be tested. Specific research into the treatment of ANP is sparse. However, several recent trials have shown that both tramadol and gabapentin are useful in mitigating neuropathic cancer pain. In addition, a recent trial suggests a combination of neural blockade with memantine may be useful in reducing ANP. SUMMARY: The diagnosis of ANP is assisted by knowledge of the medical circumstances that have a higher risk of the condition developing, a detailed pain history with a directed examination and use of neuropathic pain scales. Although the data are lacking, agents that have demonstrated efficacy in persistent neuropathic pain states should be used in ANP. Refractory ANP could be treated with either intravenous lidocaine or calcitonin. Future research should be directed at validating a scale of neuropathic pain in ANP and conducting more therapeutic trials.
PMID: 18784484 [PubMed - indexed for MEDLINE]