Fentanilo transcutáneo en el tratamiento de la neuralgia postherpética
Transdermal fentanyl in the treatment of postherpetic neuralgia
Servicio de Dermatología. Hospital Ernest Lluch. Calatayud. Zaragoza. España
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Hospital Ernest Lluch. Calatayud. Zaragoza. España" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Hospital Ernest Lluch. Ctra. Sagunto-Burgos, km 254. 50300 Calatayud. Zaragoza. España" ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Transdermal fentanyl in the treatment of postherpetic neuralgia" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La neuralgia es el efecto secundario más importante del herpes zoster. El papel de los opioides en el tratamiento del dolor de la neuralgia postherpética está sujeto a controversia.</p> <span class="elsevierStyleSectionTitle">Material y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se ha incluido un grupo de 34 pacientes adultos de ambos sexos con neuralgia postherpética entre enero de 2001 y junio de 2002. El estudio fue prospectivo, de 3 meses de duración, y con 3 controles: basal (al cabo de un mes) y final (a los 3 meses). El objetivo de este trabajo fue valorar el uso de fentanilo en parches de 25 mg.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Los pacientes referían «bastante» alivio del dolor al finalizar el estudio en el 48% de los casos y «mucho» en el 24%. En la visita basal, 30 de los pacientes presentaban dolor de intensidad 5 o superior, cifra que descendió a 7 pacientes al final del estudio. La eficacia es excelente en el 36% de los casos y la tolerancia excelente en el 82%, los pacientes refieren encontrarse «bastante» o «mucho» mejor en el 79% de casos al finalizar el estudio.</p> <span class="elsevierStyleSectionTitle">Discusión</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El 55% de los pacientes presentaban efectos adversos en la visita basal, siendo el 33% moderados o graves, lo cual era indicativo de la mala calidad de vida. Con el tratamiento se produce un descenso de efectos secundarios y el alivio sintomático lo refieren los pacientes a los 6-8 días tras el inicio de la terapia. Se aprecia una disminución del dolor de 4,1 puntos de media en la muestra al finalizar el tratamiento, con una eficacia y una tolerancia excelentes en el 36 y el 81% de los casos, respectivamente.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El fentanilo transcutáneo es eficaz porque controla el dolor, se tolera bien y mejora la calidad de vida de los pacientes. Además, es bien aceptado por éstos, y el tratamiento de forma ambulatoria facilita su cumplimiento. Se debe elevar la dosis en cuanto se estanque la mejoría y realizar el tratamiento durante un mínimo de 6 meses para conseguir el resultado óptimo.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Neuralgia is the main secondary effect of herpes zoster. The use of opioids in the treatment of postherpetic neuralgic pain is highly controversial.</p> <span class="elsevierStyleSectionTitle">Material and method</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Thirty-four adult patients of both sexes with postherpetic neuralgia were included in this trial between January 2001 and June 2002. The study lasted for 3 months and included three visits: the first visit, a check-up visit at 1 month, and another visit at 3 months. The aim of this study was to assess the use of 25 mg transdermal fentanyl patches.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">At the end of treatment, 48% of the patients reported considerable pain relief and 24% reported great pain relief. In the first visit, 30 patients felt a pain level of 5 or above. At the end of treatment, the number of patients with this pain level was reduced to seven. Effectiveness was excellent in 36% of the patients and tolerance was excellent in 82%. At the end of treatment, 79% of the patients felt «a bit better» or «much better».</p> <span class="elsevierStyleSectionTitle">Discussion</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Fifty-five percent of the patients presented adverse effects in the first visit, 33% of which were moderate or severe, indicating poor quality of life. After 6-8 days of treatment, adverse effects were reduced and patients reported symptomatic relief. At the end of treatment, there was a mean reduction of 4.1 in the pain scale, and effectiveness and tolerance were excellent in 36 and 81% of the patients, respectively.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Transdermal fentanyl is effective as it controls pain, is well tolerated and improves patients’ quality of life. Moreover, it is well accepted by patients and outpatient treatment facilitates adherence. Doses should be increased when improvement is no longer observed and treatment should be carried out for a minimum of 6 months for optimal results.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:27 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "An overview of neuropathic pain: syndromes, symptoms, signs, and several mechanisms" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "R.H. 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