Local anesthetics for neuropathic pain
Studies have established the 5% lidocaine patch (Lidoderm) to be effective in patients with PHN. Some patients with PHN and other neuropathic pain may obtain relief from the cutaneous anesthesia provided by the eutectic mixture of lidocaine and prilocaine (EMLA) or 5% or 10% lidocaine gel or cream. Typically this is applied in a thin layer several times daily. Temporary nerve blocks with local anesthetic to both peripheral nerves and sympathetic nerves may also be beneficial in some patients. Intravenous lidocaine in a dose of 3 to 5 mg/kg can reduce neuropathic pain short term and in some cases there may be a more prolonged response.