Intravenous lidocaine infusions in a multidirectional model of treatment of neuropathic pain patients.

BACKGROUND: Neuropathic pain, is caused by damage or disease affecting the somatosensory nervous system, leads to deterioration of the quality of life of patients. Most commonly, this deterioration is due to the inefficacy of treatment or to the adverse effects of systemic treatment. Pharmacotherapy of neuropathic pain involves the use of antiepileptic agents, antidepressants, and opioids that may lead to numerous adverse effects, particularly in elderly patients. Intravenous infusions of lidocaine may improve the efficacy of the analgesic treatment of neuropathic pain patients while not causing any significant adverse effects.

METHODS: In our study, we carried out a retrospective analysis of 85 patients with various neuropathic pain syndromes. In this group, 81 patients received 3-25 intravenous infusions of lidocaine (5mg/kg of body weight over 30min). In the remaining 4 patients, the treatment was discontinued after the first infusion due to the lack of efficacy.

RESULTS: The analgesic effect of intravenous lidocaine was better when the intensity of pain experienced before the infusion was high. In addition, better effects were observed in elderly patients. No need to interrupt the infusion occurred in any of the patients. No serious adverse effects were observed either. Transient dizziness, not requiring additional treatment, occurred in 5 patients after the infusion.

CONCLUSIONS: The best therapeutic effects of lidocaine infusion was observed in pain symptoms characterized by the highest intensity of baseline pain. Intravenous lidocaine administered at the dose of 5mg/kg of body weight over 30min is effective, safe and caused no significant adverse effects.