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PAIN MEDICINE

Transdermal Buprenorphine for Treating Nociceptive and Neuropathic Pain: Four Case Studies

Rudolf Likar, MD^*, and Reinhard Sittl, MD, PhD

*Pain Clinic, General Hospital Klagenfurt, Klagenfurt, Austria; and University of Erlangen Pain Clinic, Erlangen, Germany

Address correspondence and reprint requests to Rudolf Likar, MD, Associate Professor, Head of the Interdisciplinary Pain Clinic, General Hospital Klagenfurt, St. Veither Strasse 47, 9026 Klagenfurt, Austria. Address e-mail to r.likar{at}aon.at.

The use of opioids for treating neuropathic pain is controversial, and some studies have indicated that neuropathic pain may be relatively insensitive to typical µ-opioid analgesics such as morphine. However, it is becoming clear that different opioids produce analgesia by affecting different pain pathways. We present two cases of neuropathic pain and two cases of nociceptive pain with a significant neuropathic component that were treated with transdermal buprenorphine. In each case, sufficient pain relief was obtained and no problems were encountered in switching from prior analgesic therapy with larger doses of other opioids.

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