Effect of Cooling Capsaicin Application Site on Reducing Burning Sensation in Neuropathic Pain Patients: A Randomized Controlled Trial.

Purpose: Treatment of localized neuropathic pain continues to represent an unmet need. The primary objective of the present study was to evaluate the efficacy of cryotherapy to reduce the burning pain induced by capsaicin (8%) patches (QUTENZA) in a neuropathic pain cohort. We also investigated subsequent neuropathic pain during an 8-week follow-up.

Design: The present work resulted from a prospective, randomized, two-center, open-label, interventional French trial.

Methods: This study aimed to investigate the effects of cooling of the application area of QUTENZA patches. Visual analog scale (VAS) scores were measured 30 and 60 minutes after patch application. Weekly neuropathic VAS scores were then collated for 2 months. Ninety-nine patients were included and randomized into a cryotherapy group (n = 50 [80% women], median age = 51 years old) and a no cryotherapy group (n = 49 [69% women], median age = 48 years old).

Results: Cooling at the application site of the patch resulted in a reduction by 3.20 in burning pain VAS score at 60 minutes, with no cooling VAS 6.99 (95% CI [6.2, 7.77]) versus 3.78 (95% CI [3, 4.56]) for cryotherapy. Neuropathic VAS pain scores over the follow-up period were not statistically different.

Conclusions: Cryotherapy at the application site significantly reduced the burning pain induced by capsaicin patches but had no effect on neuropathic pain for the 8 weeks following application.

Clinical implications: The use of cooling during capsaicin patch application, by ameliorating the therapeutic alliance, improves the clinical management of neuropathic pain. © 20XX by the American Society for Pain Management Nursing.