The effectiveness of treatments for neuropathic pain
DOI:
https://doi.org/10.33448/rsd-v11i10.32248Keywords:
Neuralgia; Drug therapy; Pain.Abstract
A dor neuropática é um tipo de dor crônica que advém de lesão ou doença do sistema nervoso somatossensorial, de origem central ou periférica. Trata-se de uma gama heterogênea de síndromes dolorosas, tendo diversos mecanismos fisiopatológicos e diferentes graus de intensidade de sinais e sintomas. Em razão disso, diversos são os recursos terapêuticos, sendo eles farmacológicos, físicos ou cognitivos, e empecilhos para um tratamento adequado e eficaz. Apesar dos avanços terapêuticos, apenas uma minoria dos pacientes alcança um alívio importante da dor. O trabalho visa analisar os tratamentos disponíveis para a dor neuropática e apresentar as melhores opções farmacológicas e não farmacológicas. Foi realizada uma revisão de literatura, utilizando os descritores “pain”, “neuropathy”, “treatment”, na base de dados PUBMED, com filtros para texto grátis completo, revisão sistemática e metanálise, desde 2016 até 2021. Esta revisão pontuou que há eficácia evidente ao utilizar gabapentina e pregabalina para alívio da dor neuropática. Esses medicamentos são neuromoduladores da classe antidepressivos, e ambos apresentaram melhora maior que o grupo placebo. Além disso, também se mostrou eficaz o uso de vitamina B12 (metilcobalamina) e acupuntura, este, porém, em menor escala e maior tempo de tratamento. Os estudos sobre o tratamento da dor neuropática vêm aumentando com o passar dos anos, o que nos permite pensar em avanços significativos no futuro. Atualmente utilizam-se fármacos como a pregabalina e a gabapentina ou métodos não farmacológicos como a acupuntura. Por isso, deve-se dar maior atenção aos estudos sobre os tratamentos desta enfermidade visando o bem-estar do paciente.
References
Amaniti, A., Sardeli, C., Fyntanidou, V., Papakonstantinou, P., Dalakakis, I., Mylonas, A., & Grosomanidis, V. (2019). Pharmacologic and non-pharmacologic interventions for HIV-neuropathy pain. A systematic review and a meta-analysis. Medicina, 55(12), 762.
Asrar, M. M., Kumari, S., Chandrasekhr, B., Bhansali, A., & Bansal, D. (2021). Relative efficacy and safety of pharmacotherapeutic interventions for diabetic peripheral neuropathy: a systematic review and bayesian network meta-analysis. Pain Physician, 24(1), E1.
Boyd, A., Bleakley, C., Hurley, D. A., Gill, C., Hannon-Fletcher, M., Bell, P., & McDonough, S. (2019). Herbal medicinal products or preparations for neuropathic pain. Cochrane Database of Systematic Reviews, (4).
Bula-Oyola, E.. Belda-Lois, J. M., Porcar-Seder, R., & Page, Á. (2021). Effectiveness of electrophysical modalities in the sensorimotor rehabilitation of radial, ulnar, and median neuropathies: A meta-analysis. PloS one, 16(3), e0248484.
Cooper, T. E., Chen, J., Wiffen, P. J., Derry, S., Carr, D. B., Aldington, D., ... & Moore, R. A. (2017). Morphine for chronic neuropathic pain in adults. Cochrane database of systematic reviews, (5).
Derry, S., Bell, R. F., Straube, S., Wiffen, P. J., Aldington, D., & Moore, R. A. (2019). Pregabalin for neuropathic pain in adults. Cochrane Database of Systematic Reviews, (1).
Derry, S., Rice, A. S., Cole, P., Tan, T., & Moore, R. A. (2017). Topical capsaicin (high concentration) for chronic neuropathic pain in adults. Cochrane Database of Systematic Reviews, (1).
Di Stefano, G., Di Lionardo, A., Galosi, E., Truini, A., & Cruccu, G. (2019). Acetyl-L-carnitine in painful peripheral neuropathy: a systematic review. Journal of pain research, 12, 1341.
Dimitrova, A., Murchison, C., & Oken, B. (2017). Acupuncture for the treatment of peripheral neuropathy: a systematic review and meta-analysis. The Journal of Alternative and Complementary Medicine, 23(3), 164-179.
Dimitrova, A., Murchison, C., & Oken, B. (2018). The case for local needling in successful randomized controlled trials of peripheral neuropathy: A follow-up systematic review. Medical acupuncture, 30(4), 179-191.
Duan, Y. H., Liu, A. X., Su, H. X., Lv, J. H., Gong, X. Y., & Wang, L. (2020). Effectiveness of acupuncture combined mecobalamin in the treatment of elderly diabetic peripheral neuropathy: A protocol of systematic review and meta-analysis. Medicine, 99(23).
Julian, T., Syeed, R., Glascow, N., Angelopoulou, E., & Zis, P. (2020). B12 as a Treatment for peripheral neuropathic pain: a systematic review. Nutrients, 12(8), 2221.
Kolber, M. R., Ton, J., Thomas, B., Kirkwood, J., Moe, S., Dugré, N., & Perry, D. (2021). PEER systematic review of randomized controlled trials: management of chronic low back pain in primary care. Canadian Family Physician, 67(1), e20-e30.
Li, K., Giustini, D., & Seely, D. (2019). A systematic review of acupuncture for chemotherapy-induced peripheral neuropathy. Current Oncology, 26(2), 4261.
Liampas, A., Rekatsina, M., Vadalouca, A., Paladini, A., Varrassi, G., & Zis, P. (2021). Pharmacological management of painful peripheral neuropathies: a systematic review. Pain and Therapy, 10(1), 55-68.Pain and Therapy , v. 10, n. 1, p. 55-68.
Ogle, T., Alexander, K., Miaskowski, C., & Yates, P. (2020). Systematic review of the effectiveness of self-initiated interventions to decrease pain and sensory disturbances associated with peripheral neuropathy. Journal of Cancer Survivorship, 14(4), 444-463.
Hou, S., Huh, B., Kim, H. K., Kim, K. H., & Abdi, S. (2018). Treatment of chemotherapy-induced peripheral neuropathy: systematic review and recommendations. Pain Physician, 21(6), 571.
Robinson, C. C., Barreto, R. P. G., & Plentz, R. D. M. (2018). Effects of whole body vibration in individuals with diabetic peripheral neuropathy: a systematic review. Journal of musculoskeletal & neuronal interactions, 18(3), 382.
Rolim, L. C., da Silva, E. M., Flumignan, R. L., Abreu, M. M., & Dib, S. A. (2019). Acetyl-L-carnitine for the treatment of diabetic peripheral neuropathy. The Cochrane database of systematic reviews, 6(6).
Rolim, L. C., Koga da Silva, E. M., De Sá, J. R., & Dib, S. A. (2017). A systematic review of treatment of painful diabetic neuropathy by pain phenotype versus treatment based on medical comorbidities. Frontiers in Neurology, 8, 285.
Wang, L. Q., Chen, Z., Zhang, K., Liang, N., Yang, G. Y., Lai, L., & Liu, J. P. (2018). Zusanli (ST36) acupoint injection for diabetic peripheral neuropathy: a systematic review of randomized controlled trials. The Journal of Alternative and Complementary Medicine, 24(12), 1138-1149.
Wei, W., Zhang, Y., Chen, R., Qiu, X., Gao, Y., & Chen, Q. (2020). The efficacy of vitamin D supplementation on painful diabetic neuropathy: Protocol for a systematic review and meta-analysis. Medicine, 99(31).
Wiffen, P. J., Derry, S., Bell, R. F., Rice, A. S., Toelle, T. R., Phillips, T., & Moore, R. A. (2017). Gabapentin for chronic neuropathic pain in adults. Cochrane Database of Systematic Reviews, (6).
Zeng, H., Pacheco-Barrios, K., Cao, Y., Li, Y., Zhang, J., Yang, C., & Fregni, F. (2020). Non-invasive neuromodulation effects on painful diabetic peripheral neuropathy: a systematic review and meta-analysis. Scientific reports, 10(1), 1-11.
Zhou, M., Chen, N., He, L., Yang, M., Zhu, C., & Wu, F. (2017). Oxcarbazepine for neuropathic pain. Cochrane Database of Systematic Reviews, (12).
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Copyright (c) 2022 Carlos Gonzaga Melo Filho; Bianca Maranhão Vieira; Lethícia Maria Morais Gonzalez ; Ítalo Moraes Castro; Ana Maria Silva Lima; Catarina Gomes Chaves; Monique da Silva Portela; Renata Correia Freire; Rafael Sousa Araújo Ferreira; Joana Katya Veras Rodrigues Sampaio Nunes
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