• Matias Orellana Silva, Veronica Yañez, Gabriela Hidalgo, Fernando Valenzuela, and Rolando Saavedra.
• Pain Unit, Department of Rehabilitation, COANIQUEM (Corporation of Aid to Burned Children), Santiago, Chile. morellana@coaniquem.cl
• Pain Med. 2013 Mar 1;14(3):422-9.

ObjectiveNeuropathic pain is a challenge in children with burn sequelae. Although relatively infrequent, the intensity and chronicity of neuropathic pain negatively impact functionality and quality of life. The use of 5% lidocaine medicated plaster has not previously been reported in children. We explored the effectiveness and safety of 5% lidocaine medicated plaster to treat neuropathic pain in children with burn sequelae.DesignThree-month prospective, uncontrolled study.SettingCorporation of Aid to Burned Children (COANIQUEM), a nonprofit pediatric burn rehabilitation center in Chile.SubjectsFourteen pediatric patients with burn sequelae neuropathic pain.Outcome MeasuresDemographics, burn and pain evolution (type, intensity [using Wong-Baker FACES], and Douleur Neuropathique 4 [DN4]), and patient functionality. Plasma lidocaine levels were measured at 0, 12, 36, and 60 hours after treatment commencement.ResultsFourteen patients were evaluable for plasma lidocaine levels. Twelve patients were available for clinical assessment (two patients lost to follow-up) [mean (standard deviation)]: age, 11 years 7 months (2 years 6 months); weight, 45 kg (11.9 kg); burn evolution, 5 years 6 months (4 years); time between burn and pain onset, 3 years 6 months (3 years 2 months); time between pain onset and treatment, 5.1 months (4.8 months); lidocaine, between < and ½ plaster; initial pain intensity (FACES), 6.8 (1.6); final pain intensity, 0 in 11/12 patients; DN4, initial-6, final-2.3. All patients reported improved functionality. Plasma lidocaine levels were ≤27.45 ng/mL (>180 times below critical levels). No adverse reactions occurred.ConclusionsThese are the first published data suggesting that 5% lidocaine medicated plaster improves patient functionality, and is effective and safe for the treatment of neuropathic pain in pediatric patients with burn sequelae.Wiley Periodicals, Inc.

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