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RCTs evaluating the safety and using clear diagnostic criteria for NeuP are
required as there is lack of data on the numerous treatment options for NeuP.
Although various interventions are available for neuropathic pain (NeuP), but its treatment remains unsatisfactory. So evidence on interventions for NeuP which were taken systematic reviews (SRs) of randomized controlled trials was systematically summarized. For this 5 electronic databases were searched up to March 2015. A Measurement Tool was used to analyze study quality to Assess Systematic Reviews. In 97 included SRs, the most common interventions were pharmacologic (59%) and surgical (15%). It was observed that most of the analyzed SRs were of medium quality. More than 50% of conclusions from abstracts on efficacy and approximately 80% on safety were inconclusive. Effective interventions were described for painful diabetic neuropathy (Pregabalin, Gabapentin, certain tricyclic antidepressants [TCAs], opioids, antidepressants, and anticonvulsants). For postherpetic neuralgia (Gabapentin, Pregabalin, certain TCAs, antidepressants and anticonvulsants, opioids, Sodium valproate, topical Capsaicin, and Lidocaine). Lumbar radicular pain (epidural corticosteroids, repetitive transcranial magnetic stimulation [rTMS], and discectomy). Cervical radicular pain (rTMS), carpal tunnel syndrome (carpal tunnel release), cubital tunnel syndrome (simple decompression and ulnar nerve transposition), trigeminal neuralgia (Carbamazepine, Lamotrigine, and Pimozide for refractory cases, rTMS), HIV-related neuropathy (topical Capsaicin), and central NeuP (certain TCAs, Pregabalin, Cannabinoids, and rTMS).
Evidence for interventions for NeuP is usually inconclusive or completely
lacking. It is required for more new randomized controlled trials about
interventions for NeuP which should address safety and use clear diagnostic
criteria.
Anesth Analg. 2017 Aug;125(2):643-652
Interventions for Neuropathic Pain: An Overview of Systematic Reviews
Dosenovic S et. al.
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