Transdermal Lidocaine and Ketamine for Neuropathic Pain: A Study of Effectiveness and Tolerability

BACKGROUND: Acute neuropathic pain is a common disorder. Transdermal cream could be an alternative to oral medications. OBJECTIVE: To evaluate the effectiveness and tolerability of transdermal Lidocaine and Ketamine for acute neuropathic pain. STUDY DESIGN: Retrospective chart review SETTING: University-affiliated outpatient Physiatry clinic METHODS: articipants: neuropathic pain with a prescription of a transdermal cream containing Lidocaine and Ketamine. Ef-fectiveness was evaluated by the number of patients with improvement divided by the total number of patients who re-ceived a prescription of the cream. RESULTS: A total of 854 patient charts were reviewed. Twenty-one patients with symptoms, signs, and/or a documented di-agnosis of neuropathic pain and had been given a prescription of a transdermal preparation containing Lidocaine and Ketamine. Four groups were identified: those with a clearly stated diagnosis of neuropathic pain and prescribed a transdermal compound containing Lidocaine and Ketamine with follow-up (Group A) or without follow-up (Group B), and those with a suggested diagnosis of neuropathic pain with (Group C) or without follow-up (Group D). Effectiveness of the cream was seven out of eight (87%) for Group A and one out of three (33%) for Group C. In total, eight out of 11 patients (73%) benefited from a cream containing Lidocaine and Ketamine. Two patients experienced skin reactions that led to discontin-uation of treatment. LIMITATIONS: This is a retrospective chart review without control group. CONCLUSION: Transdermal cream containing Ketamine and Lidocaine was effective in 73% of patients with acute neuro-pathic pain and may be a good alternative to oral medications.