Treatment of DPN with 8% topical capsaicin without the use of a topical anesthetic

Abstract

PURPOSEA qualitative study was done to look at the use of 8% topical capsaicin without the use of a topical anesthetic prior to treatment of DPN. In the PI it is indicated to anesthetize the affected area with topical lidocaine prior to the treatment for painful diabetic peripheral neuropathy of the feet. Many patients with diabetic peripheral neuropathy have significant numbness in their feet and limited feeling and there may not be a need for a topical anesthetic prior to application of the topical system. Applying a topical anesthetic can be time consuming to allow it to take full effect and may not be necessary. For the purposes of this study the clinics ethics committee was consulted, and approval was granted. METHODSIs topical anesthetic necessary before the procedure for the treatment of painful diabetic peripheral neuropathy with 8% topical capsaicin? 15 patient charts were reviewed at random that had received treatment with administered 8% topical capsaicin patches for their diabetic peripheral neuropathy. No topical anesthetic was used prior to the procedure. The patient was monitored throughout the procedure and ice was offered to place over the top of the patch, if needed for administration site pain. RESULTSMost patient's that did not have a topical anesthetic prior to their procedure of 8% topical capsaicin for the treatment of painful diabetic peripheral neuropathy, tolerated the procedure well without any significant increased pain or the need for interventions, such as ice. CONCLUSIONTopical anesthetic can be time consuming and cumbersome. In many patients with severe diabetic peripheral neuropathy that has resulted in significant paresthesia, a topical anesthetic is not necessary due to the patient's limited feeling in the feet. This results in a more streamline process with less time for the patient to be in the office.