Multiple lidocaine infusions for relief of neuropathic pain: systematic review and meta-analysis

Abstract

The information provided through this project must be assessed and criticized by the physician responsible for the conduct that will be adopted, depending on the conditions and the clinical status of each patient.

Long-term pain outcomes after serial lidocaine infusion in participants with recent onset of peripheral neuropathic pain: A pilot double-blind, randomized, placebo-controlled trial

“…Still, multiple lidocaine infusions of 3 mg/kg and 240 mg in chronic neuropathic pain and fibromyalgia over a period of once a week for 4 weeks have not been shown to have persistent benefits at 4 weeks and 8 weeks. [17,27,30,31]…”

“…Still, multiple lidocaine infusions of 3 mg/kg and 240 mg in chronic neuropathic pain and fibromyalgia over a period of once a week for 4 weeks have not been shown to have persistent benefits at 4 weeks and 8 weeks. [17,27,30,31] In 1 previous study, the analgesic duration of 5 mg/kg lidocaine infusion was 6 hours longer than placebo, and some study participants reported a duration of analgesic effect longer than 7 days. [19] Tremont-Lukats et al [32] reported that a 5 mg/kg of lidocaine infusion for 6 hours was more effective than 1 or 3 mg/ kg to treat neuropathic pain.…”

“…[15] Later studies and meta-analyses have confirmed the efficacy of lidocaine infusions for reducing the intensity of a variety of neuropathic pain conditions, such as spinal injury pain, central pain syndromes, diabetic peripheral neuropathy, postherpetic neuralgia, trigeminal neuralgia, and complex regional pain syndrome. [16,17] More recent studies have found intravenous lidocaine therapy to be effective for treating central and peripheral neuropathic pain. [18] The total dose of lidocaine infusion used to treat neuropathic pain has commonly ranged from 1 to 5 mg/kg.…”

“…[19] Although clinical trials have evaluated the short-term efficacy of multiple lidocaine infusions in various chronic pain conditions, no study has evaluated this intervention in early-onset of neuropathic pain and its longer-term efficacy of up to 12 weeks. [17] Prior to the commencement of the current study, we considered a number of factors regarding the dose of lidocaine to study, the study population, and the best follow-up period. Following this discussion, we determined that the 3 mg dose is 1 that clinicians commonly use, so it would be important to evaluate its effects, the 3 mg has fewer side effects than larger doses, so if this dose was found to be effective, this would provide important information, an early-onset peripheral neuropathic pain population is important to study, given their risk for the development of persistent pain, and the possibility of reducing that risk with lidocaine treatment, and longer-term outcomes (e.g., up to 12 weeks) are rarely studied, yet findings regarding the longer-term outcomes (e.g., the development of chronic pain over the longer-term) are important.…”

“…[19] Although clinical trials have evaluated the short-term efficacy of multiple lidocaine infusions in various chronic pain conditions, no study has evaluated this intervention in early-onset of neuropathic pain and its longer-term efficacy of up to 12 weeks. [17]…”