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Use of Compounded Topical Analgesics—Results of an Internet Survey
  1. Timothy J. Ness, M.D., Ph.D.,
  2. Leslye Jones, M.D. and
  3. Howard Smith, M.D.
  1. From the Department of Anesthesiology, University of Alabama at Birmingham (T.J.N., L.J.), Birmingham, Alabama; and the Arnold Pain Management Center, Beth Israel Deaconess Medical Center, Boston, Massachusetts (H.S.).
  1. Reprint requests: Timothy J. Ness, M.D. Ph.D., Department of Anesthesiology, ZRB 937, University of Alabama at Birmingham, 1530 Third Ave South, Birmingham, AL 35294-0007. E-mail: tim.ness{at}


Topically applied single or multiagent analgesics compounded by specialty pharmacies are utilized by an unknown number of pain clinicians to unknown effect. To assess the use and perceived efficacy of these agents, an e-mail survey of members of the American Society of Regional Anesthesia and Pain Medicine was performed. Response rate was low, but identified use of compounded topical agents throughout the United States. Of the 120 clinicians responding, 27% (n = 32) reported that they prescribed compounded topical analgesics containing 1 to 5 agents (mean + SEM; 2.6 ± 0.2) in their practice 3.5 ± 0.6 times per month. Use of 36 different agents of varying concentrations was reported. These clinicians perceived that 43% ± 4% of treated patients responded favorably to the topical agents with an average of 47% ± 3% pain relief and few side effects. Despite favorable reports of benefit, most clinicians perceived use of such compounded agents in their regions to generally be “little or none.”

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  • Supported by the Department of Anesthesiology, University of Alabama at Birmingham.