Intravenous lidocaine in the management of various chronic pain states. A review of 211 cases

Abstract

During a 4-year period, 211 patients were treated for various chronic pain states with infusion of intravenous (IV) lidocaine. Patients received between 1 and 5 mg/kg administered over 5-35 minutes. Responses were graded 0 (no response), 1 (partial pain relief), or 2 (complete pain relief). Results were assessed by case review at the end of 4 years. Eighty-three patients (46%) of 182 included in the study reported partial or complete pain relief on at least one occasion. These responders included patients with radicular low back pain and various peripheral neuropathies. Nonresponders included patients with mechanical back pain, myofascial syndromes, phantom limb pain, and postherpetic neuralgia. The duration of relief was variable but was far in excess of what could be predicted from CNS-depressant effects. The conclusion is that repeat intravenous infusions of lidocaine solution can be useful in the management of certain chronic pain states.