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Recommendations for Neuropathic Pain Treatment

Vida Demarin
Vanja Bašić-Kes
Iris Zavoreo
Marijana Bosnar-Puretić
Krešimir Rotim
Velimir Lupret
Mladen Perić
Željko Ivanec
Lidija Fumić
Ivo Lušić
Anka Aleksić-Shihabi
Biserka Kovač
Mira Ivanković
Helena Škobić
Boris Maslov
Natan Bornstein
Kurt Niederkorn
Osman Sinanović
Tanja Rundek

Abstract

Damage to the somatosensory nervous system poses a risk for the development of neuropathic pain. Such an injury to the nervous system results in a series of neurobiological events resulting in sensitization of both the peripheral and central nervous system. The symptoms include continuous background pain (often burning or crushing in nature) and spasmodic pain (shooting, stabbing or -electrical.). The diagnosis of neuropathic pain is based primarily on the history and physical examination finding. Although monotherapy is the ideal approach, rational polypharmacy is often pragmatically used. Several classes of drugs are moderately effective, but complete or near-complete relief is unlikely. Antidepressants and anticonvulsants are most commonly used. Opioid analgesics can provide some relief but are less effective than for nociceptive pain; adverse effects may prevent adequate analgesia. Topical drugs and a lidocaine-containing patch may be effective for peripheral syndromes. Sympathetic blockade is usually ineffective except for some patients with complex regional pain syndrome.

Keywords

Neuralgia - etiology; Neuralgia - physiopathology; Neuralgia - therapy; Pain - therapy; Guideline; Practice - guideline

Hrčak ID:

30836

URI

https://hrcak.srce.hr/30836

Publication date:

1.9.2008.

Article data in other languages: croatian

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