Clinical Study of Dermal Patch Anesthesia

Research Project

Project/Area Number	10671452
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Single-year Grants
Section	一般
Research Field	Anesthesiology/Resuscitation studies
Research Institution	Kurume University
Principal Investigator	SANO Tomomi School of Medicine, Kurume University Assistant, 医学部, 助手 (60196300)
Co-Investigator(Kenkyū-buntansha)	KANO Tatsuhiko School of Medicine, Kurume University Professor, 医学部, 教授 (50040605) FUKUSHIGE Tetsushi School of Medicine, Kurume University Lecturer, 医学部, 助手 (80181254) IRIE Masayuki School of Medicine, Kurume University Assistant, 医学部, 助手 (30268940) 増田裕一久留米大学, 医学部, 講師 (00199704)
Project Period (FY)	1999 – 2000
Project Status	Completed (Fiscal Year 1999)
Budget Amount *help	¥3,100,000 (Direct Cost: ¥3,100,000) Fiscal Year 1999: ¥500,000 (Direct Cost: ¥500,000) Fiscal Year 1998: ¥2,600,000 (Direct Cost: ¥2,600,000)
Keywords	dermal patch anesthesia / lidocaine / dibucaine / 貼付型局所麻酔薬
Research Abstract	Background. Lidocaine tape (PenlesTM) is used widely to reduce pain at venipuncture. However, dermal patch anesthesia with PenlesTM is too weak to treat allodynia, in post herpetic neuralgia (PHN) or complex regional pain syndrome (CRPS) in many hospitals have tried ten% lidocaine gel (L-gel) Which we have developed is nowadays is in clinical use for allodynia. There are several reports that patients complained of skin troubles, such as redness or exfoliation after treatment with L-gel. We have compared the conventional L-gel with a newly developed 10% dibucaine gel (D-gel) in patients with allodynia. Methods. 1) 10 healthy volunteers: Both L-gel and D-gel with separately applied oil their arm. Approximately 0.3 g of each gel was applied and sealed with TegadermTM. (A) We measured the application time until they felt no pain at pin-prick test. Both groups (applied L- or D-gel) needed 60-90 minutes. (B) We measured an effective duration after removing gel, applied 2,5, l2 and 24 hours. 2 … More ) Clinical application: L-gel and D-gel were applied 6 times and 10 times , respectively, in 12 patients (PHN 8, CRPS 4) with allodynia. 4 patients (PHN 2, CRPS 2) out of l2 received both gels at different time. Results. 1) Healthy volunteers: Both L-gel and D-gels needed 60-90 minutes of dermal patch to gel analgesia on the spot. Hypesthesia (less than 5/10) continued until 60 minutes after removal in both of the gels. The skin should different appearances after removal of the gels; L-gel with uneven white protrusion, and D-gel with flat erythema. Skin exfoliation was observed after removing gel in most of the L-gel group. 2) Clinical application: Allodynia was reduced in 2 of 6 applications(33%) in L-gel and in 8 of 10 applications(80%) in D-gel. Two patients (PHN 1,CRPS 1) receiving both L- and D-gels had reduction of allodynia with only D-gel. Another 1 patient (PHN) out of 4 patients in Whom allodynia was redued with both gels, he interrupted L-gel application because of blister formation. In the remaining of 4 patients allodyina was not reduced. Some patients receiving these gels complained of skin troubles, such as redness, exfoliation and pigmentation. Conclusion. A newly developed D-gel is superior to the conventional than L-gel in the treatment of allodynia. Less