Intravenous lidocaine for neuropathic pain: Diagnostic utility and therapeutic efficacy
- Ian Carroll MD, MS
- … show all 1 hide
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Lidocaine is a use-dependent sodium channel blocker that produces analgesia when administered intravenously to patients with neuropathic pain. This article reviews the role and limitations of intravenous lidocaine infusions for neuropathic pain. Lidocaine infusions rarely provide relief that persists significantly beyond the duration of the infusion. Diagnostically, systemic lidocaine may help establish the presence of neuropathic pain and the responsivity to oral sodium channel blockade. However, the data supporting diagnostic infusions remain sparse. Therapeutically, infusions should generally be restricted to patients with neuropathic pain who are unable to take oral medication.
- Devor M, Wall PD, Catalan N: Systemic lidocaine silences ectopic neuroma and DRG discharge without blocking nerve conduction. Pain 1992, 48:261–268. CrossRef
- Woolf CJ, Wiesenfeld-Hallin Z: The systemic administration of local anaesthetics produces a selective depression of C-afferent fibre evoked activity in the spinal cord. Pain 1985, 23:361–374. CrossRef
- Sotgiu ML, Biella G, Castagna A, et al.: Different time-courses of i.v. lidocaine effect on ganglionic and spinal units in neuropathic rats. Neuroreport 1994, 5:873–876. CrossRef
- Attal N, Gaude V, Brasseur L, et al.: Intravenous lidocaine in central pain: a double-blind, placebo-controlled, psychophysical study. Neurology 2000, 54:564–574.
- Leong MS, Solvason HB: Case report: limbic system activation by intravenous lidocaine in a patient with a complex regional pain syndrome and major depression. Pain Med 2000, 1:358–361. CrossRef
- Benson BE, Carson RE, Kiesewetter DO, et al.: A potential cholinergic mechanism of procaine’s limbic activation. Neuropsychopharmacology 2004, 29:1239–1250. CrossRef
- Parekh PI, Spencer JW, George MS, et al.: Procaine-induced increases in limbic rCBF correlate positively with increases in occipital and temporal EEG fast activity. Brain Topogr 1995, 7:209–216. CrossRef
- Servan-Schreiber D, Perlstein WM, Cohen JD, Mintun M: Selective pharmacological activation of limbic structures in human volunteers: a positron emission tomography study. J Neuropsychiatry Clin Neurosci 1998, 10:148–159.
- Mao J, Chen LL: Systemic lidocaine for neuropathic pain relief. Pain 2000, 87:7–17. CrossRef
- Tremont-Lukats IW, Challapalli V, McNicol ED, et al.: Systemic administration of local anesthetics to relieve neuropathic pain: a systematic review and meta-analysis. Anesth Analg 2005, 101:1738–1749. CrossRef
- Rathmell JP, Ballantyne JC: Local anesthetics for the treatment of neuropathic pain: on the limits of meta-analysis. Anesth Analg 2005, 101:1736–1737. CrossRef
- Attal N, Rouaud J, Brasseur L, et al.: Systemic lidocaine in pain due to peripheral nerve injury and predictors of response. Neurology 2004, 62:218–225.
- Galer BS, Miller KV, Rowbotham MC: Response to intravenous lidocaine infusion differs based on clinical diagnosis and site of nervous system injury. Neurology 1993, 43:1233–1235.
- Schnider T, Gaeta TW, Brose RR, et al.: Derivation and cross-validation of pharmacokinetic parameters for computer-controlled infusion of lidocaine in pain therapy. Anesthesiology 1996, 84:1043–1050. CrossRef
- Galer BS, Harle J, Rowbotham MC: Response to intravenous lidocaine infusion predicts subsequent response to oral mexiletine: a prospective study. J Pain Symptom Manage 1996, 12:161–167. CrossRef
- Marchettini P, Lacerenza M, Marangoni C, et al.: Lidocaine test in neuralgia. Pain 1992, 48:377–382. CrossRef
- Boas RA, Covino BG, Shahnarian A: Analgesic responses to i.v. lignocaine. Br J Anaesth 1982, 54:501–505. CrossRef
- Dirks J, Fabricius P, Petersen KL, et al.: The effect of systemic lidocaine on pain and secondary hyperalgesia associated with the heat/capsaicin sensitization model in healthy volunteers. Anesth Analg 2000, 91:967–972. CrossRef
- Gilron I, Bailey J, Weaver DF, Houlden RL: Patients’ attitudes and prior treatments in neuropathic pain: a pilot study. Pain Res Manag 2002, 7:199–203.
- Berger A, Dukes EM, Oster G: Clinical characteristics and economic costs of patients with painful neuropathic disorders. J Pain 2004, 5:143–149. CrossRef
- Zehender M, Geibel A, Treese N, et al.: Prediction of efficacy and tolerance of oral mexiletine by intravenous lidocaine application. Clin Pharmacol Ther 1988, 44:389–395. CrossRef
- Orza F, Boswell MV, Rosenberg SK: Neuropathic pain: review of mechanisms and pharmacologic management. NeuroRehabilitation 2000, 14:15–23.
- Dworkin RH, Backonja M, Rowbotham MC, et al.: Advances in neuropathic pain: diagnosis, mechanisms, and treatment recommendations. Arch Neurol 2003, 60:1524–1534. CrossRef
- Collins SL, Moore RA, McQuay HJ, Wiffen P: Antidepressants and anticonvulsants for diabetic neuropathy and postherpetic neuralgia: a quantitative systematic review. J Pain Symptom Manage 2000, 20:449–458. CrossRef
- Chaplan SR, Bach FW, Shafer SL, Yaksh TL: Prolonged alleviation of tactile allodynia by intravenous lidocaine in neuropathic rats. Anesthesiology 1995, 83:775–785. CrossRef
- Sinnott CJ, Garfield JM, Strichartz GR: Differential efficacy of intravenous lidocaine in alleviating ipsilateral versus contralateral neuropathic pain in the rat. Pain 1999, 80:521–531. CrossRef
- Petersen P, Kastrup J, Zeeberg I, Boysen G: Chronic pain treatment with intravenous lidocaine. Neurol Res 1986, 8:189–190.
- Petersen P, Kastrup J: Dercum’s disease (adiposis dolorosa). Treatment of the severe pain with intravenous lidocaine. Pain 1987, 28:77–80. CrossRef
- Intravenous lidocaine for neuropathic pain: Diagnostic utility and therapeutic efficacy
Current Pain and Headache Reports
Volume 11, Issue 1 , pp 20-24
- Cover Date
- Print ISSN
- Online ISSN
- Current Science Inc.
- Additional Links
- Author Affiliations
- 1. Stanford University School of Medicine, 780 Welch Road, Suite 208E, Palo Alto, CA, 94034, USA