Intravenous Lidocaine Relieves Severe Pain: Results of an Inpatient Hospice Chart Review

Thomas, Jaime; Kronenberg, Robert; Cox, Michael C.; Naco, Gilbert C.; Wallace, Mark; Gunten, Charles F. von

doi:10.1089/jpm.2004.7.660

Cited by 44 publications

(48 citation statements)

References 36 publications

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“…The overall incidence of adverse events with lidocaine was the same as with placebo, and no adverse events were specifically attributable to pharmacologic effects. These data are consistent with the established safety profile of lidocaine when it is used either locally or intravenously (19,20).…”

Section: Discussionsupporting

confidence: 85%

Novel topical formulation of lidocaine provides significant pain relief for intrauterine device insertion: pharmacokinetic evaluation and randomized placebo-controlled trial

Tornblom-Paulander

Tingåker

Werner

et al. 2015

Fertility and Sterility

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Section: Discussionsupporting

confidence: 85%

Novel topical formulation of lidocaine provides significant pain relief for intrauterine device insertion: pharmacokinetic evaluation and randomized placebo-controlled trial

Tornblom-Paulander

Tingåker

Werner

et al. 2015

Fertility and Sterility

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“…The only unexpected event was related to the administration of parenteral lidocaine as an analgesic. 17,18 Serum concentrations of lidocaine reached levels beyond those expected from a linear increase in dosage, probably due to better absorption from the subcutaneous space. Further study is required to determine optimal dosages of lidocaine or other drugs for which systemic levels require monitoring.…”

Section: Discussionmentioning

confidence: 97%

Initial Experiences with Subcutaneous Recombinant Human Hyaluronidase

Pirrello

Chen

Thomas

2007

Journal of Palliative Medicine

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We report here our retrospective observations on the use of recombinant human hyaluronidase (rHuPH20) for the facilitation of subcutaneous hydration and drug infusion. Thirty-two patients were treated with rHuPH20 in a hospice setting over a 6-month period. Of these, 26 received this agent to enhance hypodermoclysis with standard hydration fluids for symptom control of delirium, myoclonus and mild to moderate dehydration. Flow rates up to 500 mL/hr were attained without difficulty. Electrolyte replacement in hydration fluid was achieved without incident in 5 patients receiving potassium and in 1 patient receiving both potassium and magnesium. In addition to use for hydration, 6 patients received recombinant human hyaluronidase to enhance subcutaneous infusion of 9 medications, primarily because the medication dosage required subcutaneous flow rates greater than the standard 3 mL/hr. There were no significant adverse events. Induration at the infusion site occurred in 1 patient receiving hydration and higher than expected serum lidocaine concentration was observed in another patient. Based on our positive initial experience with recombinant human hyaluronidase, there is interest in expanding its use in our facility in both the inpatient and outpatient settings.

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“…A second retrospective cohort study evaluated IV lidocaine for acute on chronic pain in 82 hospice patients requiring an inpatient admission . Patients received lidocaine 1–2 mg/kg over 15–20 minutes followed by a continuous infusion of 1 mg/kg/hour for an unspecified duration.…”

Section: Resultsmentioning

confidence: 99%

Intravenous Lidocaine for Acute Pain: A Systematic Review

et al. 2018

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This systematic review evaluates the safety and efficacy of intravenous (IV) lidocaine for the treatment of acute pain in adult patients. The PubMed database was searched for randomized controlled trials, retrospective cohort studies, case series, and case reports evaluating the use of IV lidocaine for the treatment of acute pain in adult patients, published between January 1970 and January 2018. The primary outcome was pain reduction via the Visual Analog Scale, Verbal Rating Scale, or Numeric Rating Scale among patients treated with IV lidocaine and placebo or active controls. Safety outcomes included both nonserious and serious adverse events. A total of 347 titles and abstracts were screened, and after full‐text review, 13 studies met the inclusion criteria involving 512 patients. The four active controls studied were IV morphine, IV ketorolac, IV dihydroergotamine (DHE), and IV chlorpromazine (CPZ). The dosing of IV lidocaine varied among studies between a weight‐based dose of a 1‐ to 2‐mg/kg bolus, a fixed‐bolus dose of 50–100 mg, and a 1‐mg/kg/hour continuous infusion. Monitoring of serum lidocaine concentrations was not done routinely. Intravenous lidocaine had superior efficacy to morphine for renal colic and critical limb ischemia, superior efficacy to DHE for acute migraine, and equivalent efficacy to ketorolac for acute radicular lower back pain. However, lidocaine was less effective than CPZ for the treatment of acute migraine. The most common adverse event reported among all studies were neurologic effects such as altered mental status and slurred speech. Due to the inconsistency in dosing, length of administration, and lack of serum monitoring, the absolute safety of IV lidocaine for acute pain is unknown. Larger, prospective studies are needed before the routine use of IV lidocaine can be recommended for all types of acute pain.

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Intravenous Lidocaine Relieves Severe Pain: Results of an Inpatient Hospice Chart Review

Abstract: Parenteral lidocaine appears to be rapidly effective for opioid refractory pain and is well tolerated. A randomized controlled trial is needed to confirm these impressive but preliminary uncontrolled results.

Cited by 44 publications

References 36 publications

Novel topical formulation of lidocaine provides significant pain relief for intrauterine device insertion: pharmacokinetic evaluation and randomized placebo-controlled trial

Novel topical formulation of lidocaine provides significant pain relief for intrauterine device insertion: pharmacokinetic evaluation and randomized placebo-controlled trial

Initial Experiences with Subcutaneous Recombinant Human Hyaluronidase

Intravenous Lidocaine for Acute Pain: A Systematic Review

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