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Discussion

lidoderm for pain control?

we recently requested an order for a duragesic patch for an elderly lady with chronic pain who will not take anything po. The doctor called back with a lidoderm patch to chest wall qd. Has anybody used this for chronic pain before? I have seen it used for shingle pain but not chronic pain. I thought it was only for a localized neuralgia type pain. The PDR doesn't list this as a way to use it and I am concerned her pain is not being controlled.

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I see Lidoderm patches used once in awhile on some of my claimant's (ie: epichondylitis or tendonitis) but I was under the impression that the patch provides pain relief where you apply it.. could be wrong. I wouldn't think that a Lidoderm patch would be very effective with systemic chronic pain tho...

Is it working out for her?

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I don't think so, she yells out and swats at you when your turning her or trying to get her to do something. Then again there are times when she moves along just fine. It is so hard to tell with some of the dementia patients!!!

This doesn't sound like an appropriate use for a lidoderm patch. I believe they are for localized pain as well. Is someone advocating for this pt.?

For chronic systemic pain, I have personally only seen fentanyl used in patch form. I would communicate to the physician the signs that are telling you she is still having pain and then ask for a fentanyl order.

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