Analgésicos tópicos

Murilo Pereira Flores; Anita Perpetua Carvalho Rocha de Castro; Jedson dos Santos Nascimento

doi:10.1590/S0034-70942012000200010

Review Article

Analgésicos tópicos

Topical analgesics

Murilo Pereira Flores; Anita Perpetua Carvalho Rocha de Castro; Jedson dos Santos Nascimento

http://dx.doi.org/10.1590/S0034-70942012000200010 Braz J Anesthesiol, vol.62, n2, p.248-252, 2012

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Resumo

JUSTIFICATIVA E OBJETIVOS: O tratamento da dor envolve a utilização de analgésicos opioides, analgésicos comuns, anti-inflamatórios não hormonais (AINH's) e analgésicos adjuvantes. Tradicionalmente, estes fármacos são administrados por via sistêmica ou no neuroeixo. Entretanto, quando aplicados por estas vias, estão associados a efeitos colaterais importantes, os quais podem inviabilizar o seu uso. A administração tópica de analgésicos é uma alternativa. O objetivo deste trabalho é discutir os analgésicos tópicos, seus mecanismos de ação e eficácia clínica. CONTEÚDO: Trata-se de um trabalho de revisão que aborda a utilização tópica de anestésicos locais, capsaicina, clonidina, antidepressivos tricíclicos, cetamina, opioides e canabinoides, discutindo o seu mecanismo de ação e a sua eficácia. CONCLUSÕES: Os analgésicos tópicos são promissores como estratégia para o tratamento da dor, já que estão associados à menor incidência de efeitos colaterais. O benefício dos anestésicos locais, dos AINH's e da capsaicina está bem estabelecido, entretanto, a eficácia de clonidina, antidepressivos tricíclicos, cetamina, opioides e canabinoides ainda é questionável. Trabalhos demonstram que a abordagem multimodal é uma alternativa, porém estudos são necessários para confirmar esta hipótese.

Palavras-chave

ANALGESIA, ANALGÉSICOS, ANALGÉSICOS, ANALGÉSICOS, Canabinoides, ANESTESIA, Antidepressivos, Capsaicina, DOR

Abstract

BACKGROUND AND OBJECTIVES: Pain treatment involves the usage of common and opioid analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs) and adjuvant analgesics. Traditionally, these drugs are administered systemically or into the neuraxis. However, when analgesics are applied through these pathways, they are associated with significant side effects, which can hinder its use. Topical administration of analgesics is an alternative. The objective of this paper is to discuss topical analgesics, the mechanisms of action and clinical efficacy. CONTENT: This is a review paper addressing the usage of the topical local anesthetics: capsaicin, clonidine, tricyclic antidepressants, ketamine, opioids and cannabinoids, discussing mechanism of action and effectiveness. CONCLUSIONS: Topical analgesics are promising as a strategy for pain treatment, as they are associated with lower incidence of side effects. The benefit of local anesthetics, NSAID's and capsaicin is well established. However, the efficacy of clonidine, tricyclic antidepressants, ketamine, opioids and cannabinoids is still questionable. Studies have shown that the multimodal approach is an alternative, but studies are needed to confirm this hypothesis.

Keywords

Administration, Analgesia, Analgesics, Anesthetics, Antidepressive Agents, Anti-inflammatory Agents, Cannabinoids, Capsaicin, Ketamine

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Analgésicos tópicos

Topical analgesics

Murilo Pereira Flores; Anita Perpetua Carvalho Rocha de Castro; Jedson dos Santos Nascimento

Resumo

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Abstract

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