Acute Neuropathic Pain A Neglected Issue Stephan A

Acute Neuropathic Pain: A Neglected Issue! Stephan A Schug Anaesthesiology University of Western Australia Pain Medicine Royal Perth Hospital Images seen in this presentation either belong to the speaker or have been sourced by the speaker. Pfizer does not take responsibility for copyrights for the images

Typical Neuropathic Pain Syndromes • Peripheral neuropathies – Metabolic: diabetic, – Toxic: alcohol, chemotherapy, others – Postinfectious: acute shingles, PHN (post-herpetic neuralgia), HIV, CMV (cytomegalovirus) • Posttraumatic – – – Sciatica Neuroma or nerve entrapment Phantom limb pain CRPS (complex regional pain syndrome) Postsurgery Posttrauma – Burns pain !!!!! Spinal cord injury • Post-stroke pain • MS (multiple sclerosis) •

Treatment of Acute Neuropathic Pain • Opioids (including tramadol/tapentadol) play a more important role than in the chronic setting (fast onset!) • Pregabalin (more than gabapentin) is recommended over tricyclics and SNRIs (faster onset! quick titration!) • But tricyclics and SNRIs can also be used SNRI: serotonin–norepinephrine reuptake inhibitor Some of the medications listed above may not be approved in all countries for the treatment of neuropathic pain. Please refer to the Product Information (labelling) in your country. Macintyre & Schug Acute Pain Management: A Practical Guide. 4 th ed. Boca Raton: CRC Press; 2015.

Schug et al. Acute Pain Management: Scientific Evidence; ANZCA & FPMANZCA Melbourne 2015.