covid
Buscar en
Revista Colombiana de Anestesiología
Toda la web
Inicio Revista Colombiana de Anestesiología Manejo farmacológico del dolor neuropático
Journal Information
Vol. 37. Issue 4.
Pages 356-372 (November - January 2010)
Share
Share
Download PDF
More article options
Vol. 37. Issue 4.
Pages 356-372 (November - January 2010)
ARTÍCULO DE REVISIÓN
Open Access
Manejo farmacológico del dolor neuropático
Pharmacological Management of Neuropathic Pain
Visits
14080
Sandra Flórez*, Marta León**, Marcela Torres***, Felipe Reyes****, Juan Camilo Serpa****, Ana María Ríos****
* Anestesiólogo. Especialista en Dolor y Cuidado Paliativo. Grupo de Dolor y Cuidado Paliativo. Profesor Asistente, Universidad de la Sabana.
** Anestesiólogo. Especialista en Dolor y Cuidado Paliativo. Grupo de Dolor y Cuidado Paliativo. Profesor Asociado, Universidad de la Sabana.
*** Epidemióloga. Grupo de Dolor y Cuidado Paliativo, Universidad de la Sabana.
**** Internos Rotatorios, Facultad de Medicina, Universidad de la Sabana.
This item has received

Under a Creative Commons license
Article information
SUMMARY

The prevalence of neuropathic pain requires proposals for management guidelines. In some cases, the degree of severity and the difficulty of treating this disorder has resulted in poor quality of life. In Europe, reported prevalence is 5%, and chronic postoperative pain ranges between 5% and 85%, depending on the type of surgery. The purpose of this paper is to review the pharmacological options for treating neuropathic pain depending on the pathophysiology, and suggest therapeutical approaches with medications available in Colombia, included or not in the Mandatory Health Plan.

Key words:
Pain
pain threshold
neuralgia
causalgia
therapeutics (Source: MeSH, NLM)
RESUMEN

El dolor neuropático es una patología cuya prevalencia requiere proponer guías de manejo. Su severidad y, en algunos casos, dificultad para el tratamiento deterioran la calidad de vida. La prevalencia reportada en Europa es del 5%, y en dolor crónico post-operatorio varía entre 5 y 85% dependiendo del tipo de cirugía. El objetivo del presente artículo es revisar las alternativas farmacológicas para el manejo de dolor neuropático de acuerdo con su fundamento fisiopatológico, y presentar sugerencias para el manejo con medicamentos disponibles en Colombia, incluidos y no incluidos en el Plan Obligatorio de Salud.

Palabras clave:
dolor
umbral del dolor
neuralgia
causalgia
terapéutica. (Fuente: DeCS, BIREME)
Full text is only aviable in PDF
REFERENCIAS
[1.]
R. Treede, T. Jensen, J. Campbell, G. Cruccu, J. Dostrovsky, J. Griffin, P. Hansson, R. Hughes, T. Nurmikko, J. Serra.
Neuropathic pain. Redefinition and a grading system for clinical and research purposes.
[2.]
R. Dworkin, A. O'Connor, M. Backonja, J. Farrar, N. Finnerup, T. Jensen, et al.
Pharmacologic management of neuropathic pain: evidence-based recommendations.
Pain., 132 (2007), pp. 225-226
[3.]
M. Abrahams.
Neuropathic pain in soft tissue complaints.
Best Pract Res Clin Rheumatol., 21 (2007), pp. 223-244
[4.]
M. Davis.
What is new in neuropathic pain?.
Support Care Cancer., 15 (2007), pp. 363-372
[5.]
A. McDermott, R. Tölle, D. Rowbothan, C. Schaefer, E. Dukes.
The burden of neuropathic pain: results form a cross-sectional survey.
Eur J Pain., 10 (2006), pp. 127-135
[6.]
U. Guevara, A. Covarrubias, G. García, S. Hernández.
Parámetros de práctica clínica para el manejo de dolor neuropático.
Revista de Investigación Clínica., 58 (2006), pp. 126-138
[7.]
W. Macrae.
Chronic post surgical pain: 10 years on.
Br J Anaesth, 101 (2008), pp. 77-86
[8.]
N. Finnerup, T. Jensen.
Mechanisms of Disease: mechanism-based classification of neuropathic pain- A critical analysis.
Nat Clin Pract Neurol., 2 (2006), pp. 107-115
[9.]
R. Baron.
Mechanisms of Disease: neuropathic pain – A clinical perspective.
Nat Clin Pract Neurol., 2 (2006), pp. 95-106
[10.]
I. Gilron, C.P. Watson, C.M. Cahill, D.E. Moulin.
Neuropathic pain: a practical guide for the clinician.
CMAJ., 175 (2006), pp. 265-275
[11.]
R. Dworkin, A. O'Connor, M. Backonja, J. Farrar, N. Finnerup, T. Jensen, et al.
Pharmacological management of neuropathic pain: evidence-based recommendations.
Pain., 132 (2007), pp. 237-251
[12.]
G. Irving.
Contemporary management of neuropathic pain.
Neurology., 64 (2005), pp. S21-S27
[13.]
M. Bennet, N. Attal, M. Backonja, R. Baron, D. Bouashira, R. Freynhagen, et al.
Using screening tools to identify neuropathic pain.
Pain., 127 (2007), pp. 199-203
[14.]
D. Bouhassira, N. Attal, H. Alchaar, F. Boueau, B. Brocher, J. Bruxelle.
Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4).
[15.]
M. Bennet.
The LANSS pain scale: the Leeds assessment of neuropathic symptoms and signs.
Pain., 92 (2001), pp. 147-157
[16.]
S. Horowitz.
The Diagnostic Workup of Patients with Neuropathic Pain.
Med Clin N Am., 91 (2007), pp. 21-30
[17.]
R. Dworkin, M. Backonja, M. Rowbotham, R. Allen, C. Argof, G. Bennet, et al.
Advances in neuropathic pain: diagnosis, mechanisms and treatment recommendations.
Arch Neurol., 60 (2003), pp. 1524-1534
[18.]
G. Cruccu, P. Anand, N. Attal, L. García-Larrea, M. Haanpaa, E. Jorum, J. Serra, T. Jensen.
EFNS guidelines on neuropathic pain assessment.
Eur J of Neurol., 11 (2004), pp. 153-162
[19.]
J. Singlenton.
Evaluation and treatment of painful peripheral polyneuropathy.
Semin Neurol., 25 (2005), pp. 185-195
[20.]
D. Mellar.
What's new in neuropathic pain?.
Support Care Cancer., 15 (2007), pp. 363-372
[21.]
J. Mendell, Z. Sahenk.
Painful Sensory Neuropathy.
New Engl J Med., 348 (2003), pp. 1243-1255
[22.]
H. Chen, T. Lamer, R. Rho, K. Marshall, B. Sitzman, S. Ghazi, R. Brewer.
Contemporary Management of Neuropathic pain for the primary care physician.
Mayo Clin Proc, 79 (2004), pp. 1533-1545
[23.]
D. Bridges, S. Thompson, A. Rice.
Mechanisms of neuropathic pain.
Br J Anaest, 87 (2001), pp. 12-26
[24.]
C. Kennedy.
P2X Receptors: Targets for novel analgesics?.
The Neuroscientist., 11 (2005), pp. 345-356
[25.]
C. Woolf.
Central sensitization. Uncovering the Relation between Pain and Plasticity.
Anesthesiology., 106 (2007), pp. 864-867
[26.]
C. Woolf.
Pain: Moving from Symptom Control toward Mechanism-Specific Pharmacologic Management.
Ann Intern Med., 140 (2004), pp. 441-451
[27.]
D. Moulin, A. Clark, I. Gilron, M. Ware, C. Watson, B. Sessie, et al.
Pharmacological management of chronic neuropathic pain – Consensus statement and guidelines from the Canadian Pain Society.
Pain Res Manage., 12 (2007), pp. 13-21
[28.]
S. Sindrup, M. Otto, N. Finnerup, T. Jensen.
Antidepressants in the treatment of neuropathic pain.
Basic Clin Pharmacol Toxicol., 96 (2005), pp. 399-409
[29.]
R. Amir, C. Argoff, G. Bennet, T. Cummins, M. Durieux, P. Gerner, et al.
The Role of Sodium Channels in Chronic Inflammatory and Neuropathic Pain.
J Pain., 5 (2006), pp. s1-s29
[30.]
T. Saarto, P.J. Wiffen.
Antidepressants for neuropathic pain.
Cochrane Database of Systematic Reviews, (2007),
[31.]
J.T. Farrar, J.P. Young, L. La Moreaux, J.L. Werth, R.M. Poole.
Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale.
Pain., 94 (2001), pp. 149-158
[32.]
R. Baron.
Diagnosis and treatment of neuropathic pain.
Dtsch Arztebl, 103 (2006), pp. A 2720-A 2730
[33.]
S. Quilici, J. Chancellor, M. Lothgren, D. Simon, G. Said, T.K. Le.
Meta-analysis of duloxetine vs. pregabalin and gabapentin in the treatment of diabetic peripheral neuropathic pain.
BMC Neurol., 9 (2009), pp. 6
[34.]
S. Sindrup, F. Bach, C. Madsen, L. Gram, T. Jensen.
Venlafaxine versus imipramine in painful polyneuropathy.
Neurology., 60 (2003), pp. 1284-1289
[35.]
T. Yaksh.
Calcium channels as therapeutic targets in neuropathic pain.
[36.]
P.J. Wiffen, H.J. McQuay, J. Rees, R.A. Moore.
Gabapentin for acute and chronic pain.
Cochrane Database of Systematic Reviews, (2005),
[37.]
M. Devor.
Sodium Channels and Mechanisms of Neuropathic Pain.
[38.]
O. Casasola.
Multimodal Approaches to the Management of Neuropathic pain: The Role of Topical Analgesia.
J Pain Symp Manage., 33 (2007), pp. 356-364
[39.]
A. Gammaitoni, M. Davis.
Pharmacokinetics and tolerability of lidocaine patch 5% with extended dosing.
Ann Pharmacother., 36 (2002), pp. 236-240
[40.]
P.J. Wiffen, S. Collins, H.J. McQuay, D. Carrol, A. Jadad, R.A. Moore.
Anticonvulsant drugs for acute and chronic pain.
Cochrane Database of Systematic Reviews, (2005),
[41.]
R. Dubinsky, H. Kabbani, E. El-Chami, C. Boutwell, H. Ali.
Practice parameter: treatment of postherpetic neuralgia.
Neurology., 63 (2004), pp. 959-965
[42.]
M. Becker, D. Axelrod, O. Oyesanmi, D. Markov, E. Shakin.
Hematologic Problems in Psychosomatic Medicine.
Psychiatr Clin North Am., 30 (2007), pp. 739-759
[43.]
P.J. Wiffen, J. Rees.
Lamotrigine for acute and chronic pain.
Cochrane Database of Systematic Reviews, (2007),
[44.]
N. Attal, G. Cruccu, M. Haanpaa, P. Hansson, T. Jensen, T. Nurmikko.
EFNS guidelines on pharmacological treatment of neuropathic pain.
Eur J Neurol., 13 (2006), pp. 1153-1169
[45.]
D.K. Kochar, N. Jain, R.P. Agarwal, T. Srivastava, P. Agarwal, S. Gupta.
Sodium valproate in the management of painful neuropathy in type 2 diabetes – A randomized placebo controlled study.
Acta Neurol Scand., 106 (2002), pp. 248-252
[46.]
M. Otto, F.W. Bach, T.S. Jensen, S.H. Sindrup.
Health-related quality of life and its predictive role for analgesic effect in patients with painful polyneuropathy.
Eur J Pain., 11 (2007), pp. 572-578
[47.]
J. Hollingshead, R.M. Dühmke, D.R. Cornblath.
Tramadol for neuropathic pain.
Cochrane Database Syst Rev, 3 (2006), pp. CD003726
[48.]
E. Eisenberg, E. McNicol, D.B. Carr.
Opioids for neuropathic pain.
Cochrane Database Syst Rev, 3 (2006),
[49.]
E. Eisenberg, McNicol Ewan, D. Carr.
Efficacy and safety of Opioid Agonists in the treatment of Neuropathic Pain of Nonmalignant Origin. Systematic Review and Meta-analysis.
JAMA, 293 (2005), pp. 3043-3052
[50.]
A. Vadalouca, I. Siafaka, E. Argyra, E. Vrachnou, E. Moka.
Therapeutic management of chronic neuropathic pain: an examination of pharmacological treatment.
Ann N Y Acad Sci., 1088 (2006), pp. 164-186
[51.]
H. Smith, K. Kirsh.
Documentation and Potential Tools in Long-Term Opioid Therapy for Pain.
Anesthesiology Clin., 25 (2007), pp. 809-823
[52.]
G. Hocking, M. Cousins.
Ketamine in chronic pain Management: and evidence-based review.
Anesth Analg., 97 (2003), pp. 1730-1739
[53.]
M. Lynch, J. Sawyonk, M. Sullivan.
Topical 2% amitriptyline and 1% amitriptyline in neuropathic pain syndromes : a randomized, double-blind, placebo-controlled trial.
Anesthesiology., 103 (2005), pp. 140-146
[54.]
E. Lockart.
Topical combination of amitriptyline and ketamine for post herpetic neuralgia.
J Pain., 5 (2004), pp. 82
[55.]
M. Goldberg, R. Domsky, D. Scaringe, R. Hirsh, J. Dotson, I. Sharaf, M. Torjman, R. Schwartzman.
Multi-day low dose ketamine infusion for the treatment of complex regional pain syndrome.
Pain Physician., 8 (2005), pp. 175-179
[56.]
R. Kiefer, P. Rohr, A. Ploppa, K. Altemeyer, R. Schwartzman.
Complete recovery from intractable complex regional pain syndrome, CRPS-type I, following anesthetic ketamine and midazolam.
Pain Pract., 7 (2007), pp. 147-150
[57.]
G. Correll, J. Maleki, E. Gracely, J. Muir, R. Harbut.
Subanesthetic ketamine infusion therapy: A retrospective analysis of a novel therapeutic approach to complex regional pain syndrome.
[58.]
A. Kvarnström, R. Karlsten, H. Quilding, H. Gordh.
Acta Anest Scand., 48 (2004), pp. 498-506
[59.]
R. Shahani, C. Streutker, B. Dickson, R. Stewart.
Ketamine-associated ulcerative cystitis: A new clinical entity.
Urology., 69 (2007), pp. 810-812
[60.]
N. Finnerup, M. Otto, H. McQuay, T. Jensen, S. Sindrup.
Algorithm for neuropathic pain treatment: An evidence based proposal.
Pain., 118 (2005), pp. 289-305
[61.]
R. Gallagher.
Management of Neuropathic Pain. Translating Mechanistic Advances and Evidence-based Research into Clinical Practice.
Clin J Pain, 22 (2006), pp. s2-s8
[62.]
R. Taylor, D. Niv, P. Raj.
Exploration of the evidence.
Pain Practice., 6 (2006), pp. 10-21
[63.]
M. Jensen, M. Chodroff, R. Dworkin.
The impact of neuropathic pain on health-related quality of life.
Review and implications. Neurology., 68 (2007), pp. 1178-1182
[64.]
J.C. Acevedo, A. Amaya, L. Casasola Ode, N. Chinchilla, M. De Giorgis, S. Flórez, et al.
Guidelines for the diagnosis and management of neuropathic pain: consensus of a group of Latin American experts.
J Pain Palliat Care Pharmacother., 23 (2009), pp. 261-281
Copyright © 2009. Revista Colombiana de Anestesiología
Download PDF
Article options