BACKGROUND Neuropathic pain consistently presents a significant therapeutic challenge. Topically applied analgesics have the advantage of showing low systemic side effects, but data on long-term effectiveness are lacking. Consequently, interviews were carried out with all patients being treated with topical analgesics in hospital. METHODS Ethics 16-5690, German Clinical Trials Register (DRKS) 00011877. Between 2008 and 2017 a total of 265 patients were treated at least once with either capsaicin 8% (C), lidocaine 5% (L) and/or perineural botulinum toxin type A (B). From this sample, 205 patients (77%) were interviewed by telephone for feedback on pain reduction (first/last treatment: low/moderate/very good), the possible reduction of analgesic prescription and if applicable the reasons for discontinuation of use (time of interview C: 26 ± 19 months, L: 61 ± 23 months, B: 11 ± 6 months after start). Further pretreatment data and diagnoses were obtained from the in-house documentation system. Responders or long-term responders were defined as patients with at least one moderate pain reduction after the first or last treatment, as long as the effect was adequately maintained. RESULTS In all treatment groups (56 ± 13 years, 62% male, C: 80, L: 84, B: 58 patients) patients with a long history of pain (C: 60 ± 73 months, L: 59 ± 66 months, B: 67 ± 71 months) and high pain intensity (numeric rating scale, NRS, C: 7 ± 2, L: 7 ± 2, B: 6 ± 2), were predominant. The highest primary and long-term responder rates were exhibited by L (57%/60%, B: 52%/37%, C: 23%/15%). With B, long-term responders were most frequently able to reduce analgesic use (74%, C: 58%, L: 38%). DISCUSSION Despite the long duration of the disease, the most used off-label topical drugs L and B demonstrated a high primary response rate (in contrast to C), with most benefiting from long-term treatment.

中文翻译：

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局部应用镇痛药的长期有效性

背景神经性疼痛始终是一个重大的治疗挑战。局部应用镇痛药的优点是全身副作用低，但缺乏长期有效性的数据。因此，对所有在医院接受局部镇痛药治疗的患者进行了访谈。方法 伦理 16-5690，德国临床试验注册 (DRKS) 00011877。2008 年至 2017 年期间，共有 265 名患者接受了至少一次辣椒素 8% (C)、利多卡因 5% (L) 和/或神经周围肉毒杆菌毒素治疗类型 A (B)。从这个样本中，205 名患者 (77%) 接受了电话采访，以获取关于疼痛减轻（第一次/最后一次治疗：低/中/非常好）、镇痛药处方可能减少以及如果适用停止使用的原因（时间采访C：26±19 个月，L：61±23 个月，B：开始后 11±6 个月）。进一步的治疗前数据和诊断是从内部文件系统中获得的。反应者或长期反应者被定义为在第一次或最后一次治疗后至少有一次中度疼痛减轻的患者，只要效果得到充分维持。结果 在所有治疗组（56±13 岁，62% 男性，C：80，L：84，B：58 名患者）中，有长期疼痛病史（C：60±73 个月，L：59±66 个月， B：67 ± 71 个月）和高疼痛强度（数字评定量表，NRS，C：7 ± 2，L：7 ± 2，B：6 ± 2）占主导地位。L (57% / 60%, B: 52% / 37%, C: 23% / 15%) 表现出最高的主要和长期反应率。对于 B，长期反应者最常能够减少镇痛药的使用（74%，C：58%，L：38%）。