Plasma rico em plaquetas para o tratamento da dor neuropática: uma revisão sistemática

Abstract

Neuropathic pain represents a significant public health challenge. Traditional treatments primarily involve medications, but these approaches often lead to unsatisfactory outcomes, highlighting the need to explore alternative therapeutic strategies. Among these, platelet-rich plasma (PRP), an autologous derivative of plasma enriched with platelets, has been considered promising. This thesis aims to systematically review the literature and assess the efficacy of PRP treatment in the context of neuropathic pain syndromes. The evaluation followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and included the databases: Web of Science, Embase, PubMed, Scopus, and Cochrane Library. Eligibility was determined based on the criteria of population, intervention, comparison, outcome, and study design. The risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB2) tool. Among the 1230 identified studies, 12 randomized trials met the eligibility criteria, of which 4 were double-blinded, 6 were single-blinded, and 2 were non-blinded. The total number of randomized participants was 779, mostly female, with an average age of 50 years. Approximately 66% of the studies investigated the use of PRP in the painful condition of carpal tunnel syndrome. All studies utilized the visual analog scale (VAS) to assess pain intensity over varying periods, ranging from 1 week to 1 year. PRP treatment showed a reduction in pain intensity scores in most of the studies, with superiority over other conservative treatments. Positive effects of PRP were observed in parameters associated with carpal tunnel syndrome, evaluated by the Boston Carpal Tunnel Questionnaire (BCTQ), neurophysiological analyses, and the cross-sectional area (CSA) of the median nerve. Therefore, the analyzed studies indicate that PRP is effective in alleviating neuropathic pain, with no reports of severe complications or significant adverse effects associated with the treatment. However, it is crucial that new studies, conducted with greater methodological rigor, be undertaken to arrive at a definitive conclusion regarding the true therapeutic value of PRP in the treatment of neuropathic pain.