Repeated lidocaine infusion effective in refractory neuropathic pain
Lidocaine infusion therapy (3 mg/kg of lidocaine administered over 1 hour) provided effective short-term pain relief to patients with refractory neuropathic pain which was substantially prominent after repeated infusions were administered, reports a study published in the journal Regional Anesthesia and Pain Medicine. This research was presented at the 17th World Congress on Pain, held in Boston, Massachusetts.
Kim and associates conducted a prospective, randomized, double-blind, placebo-controlled parallel study to determine whether repeated intravenous administration of low-dose lidocaine could provide prolonged pain relief in patients with specific Neuropathic Pain.
The study compared the efficacy and safety of lidocaine infusions (3 mg/kg) in the Lidocaine infusion therapy (LIT) group and normal saline infusions in the control group once a week for 4 consecutive weeks in patients with postherpetic neuralgia or complex regional pain syndrome type II. The primary outcome was the difference in the percentage change in the 11-point numerical rating scale (NRS) pain score from baseline to after the final infusion. Secondary outcomes included pain scores during 4 weeks of follow-up and any complications. Forty-two patients completed this study protocol.
Key study findings:
- The percentage reduction in NRS pain scores after the final infusion was significantly greater in the LIT group compared with the control group. However, this pain reduction was not detectable at the 4-week follow-up.
- The difference in the percentage change in NRS pain scores was especially prominent in the LIT group after the third and fourth infusions.
- None of the study participants experienced serious complications from the treatment.
The study concluded that in patients with neuropathic pain conditions, low-dose lidocaine infusion therapy was found to be an effective treatment for short-term pain relief. Moreover repeated infusions substantially reduced pain scores, but were not sustained in the long term.