What are the instructions for using lidocaine (local anesthetic) patches for pain relief?

Lidocaine Patch Instructions for Pain Relief

Lidocaine patches should be applied to the affected area up to 3-4 times daily for adults and children over 2 years of age, with each application lasting 12 hours followed by a 12-hour patch-free period. 1

Application Guidelines

• Apply patches only to intact skin (avoid broken or irritated skin)
• Clean and dry the area before application
• Cut patches to fit the painful area if needed, but do not apply more than 3 patches at once 2
• Patches are particularly practical for use on the dorsal or plantar surface of feet 2
• Remove old patch before applying a new one
• Wash hands after handling patches

Recommended Usage Pattern

• Apply for 12 hours, then remove for 12 hours 2
• Maximum of 3 patches can be used simultaneously 2
• Do not exceed 3-4 applications per day 1
• Children under 2 years: consult a physician 1

Precautions and Warnings

• Do not apply to broken, irritated, or damaged skin
• Avoid contact with eyes
• Do not use heating pads over the patch area
• Remove patches before MRI procedures
• Do not use concurrently with other forms of lidocaine
• Topical lidocaine patches should be removed before starting intravenous lidocaine infusion 2
• Do not use lidocaine patches within 4 hours of receiving nerve blocks or other local anesthetic interventions 2

Effectiveness for Different Pain Conditions

Lidocaine patches are effective for various pain conditions:

• Neuropathic pain, especially postherpetic neuralgia 2
• Cancer-related neuropathic pain 2
• Acute herpes zoster pain 3

Advantages of Lidocaine Patches

• Minimal systemic absorption (highest blood level measured was only 0.1 μg/ml) 4
• Well-tolerated when applied on allodynic skin 4
• Provides localized pain relief without significant systemic effects 2
• Can be used as part of multimodal pain management with other analgesics 2

Anatomical Considerations

The effectiveness of lidocaine patches is consistent across different body locations, but tolerability may vary:

• Equally effective when applied to the trunk, head/neck, or extremities 5
• Application to the head/neck area may be associated with more adverse events than application to the trunk or extremities 5
• Patches can be cut to fit irregular areas but should still cover the painful area as completely as possible 4

Common Pitfalls to Avoid

1. Exceeding the maximum number of patches (3) at one time
2. Applying patches to broken or irritated skin
3. Using continuously without the recommended 12-hour patch-free period
4. Using simultaneously with other lidocaine products, which could increase risk of toxicity
5. Failing to remove old patches before applying new ones

Lidocaine patches provide a safe and effective option for localized pain relief with minimal systemic absorption, making them particularly valuable for patients who cannot tolerate systemic medications or as part of a multimodal pain management approach.