The analgesic effect of intravenous lidocaine in the treatment of chronic pain: a literature review

Abstract

RBRE-73; No. of Pages 7 r e v b r a s r e u m a t o l . 2 0 1 4;x x x(x x):xxx-xxx REVISTA BRASILEIRA DE REUMATOLOGIA w w w . r e u m a t o l o g i a . c o m . b r Available online xxx Keywords: Lidocaine Intravenous lidocaine Chronic pain a b s t r a c tBackground: pain is a public health problem, greatly impairing quality of life. Almost 80% of patients with chronic pain reported that their pain interferes with activities of daily living, and two thirds reported that the pain causes negative impact on their personal relationships.The physical and functional disability, whether temporary or permanent, compromises the professional activity and causes work absenteeism, increasing costs of health systems.Objectives: the aim of this review is to analyze, based on the literature, the analgesic effect of lidocaine administered intravenously for the treatment of chronic pain and to evaluate the reduction of pain intensity in patients with chronic pain, focusing on musculoskeletal and neuropathic etiology. Methodology: the method used was a review of the literature, consisting in searching the scientific literature on the efficacy of intravenous lidocaine infusion in the treatment of patients with chronic pain. Content: of the 19 studies reviewed, 12 had results that confirm the analgesic effect of intravenous lidocaine in patients with chronic pain. Most authors used doses of 5 mg/kg infused for 30 minutes or more, producing significant analgesia with variable duration (minutes to weeks). Conclusions: based on the literature review, it is not possible to uniformly specify the most effective and safe dose of lidocaine administered intravenously for the treatment of neuropathic or musculoskeletal pain. As for effectiveness, the intravenous infusion of lidocaine as an alternative for the treatment of chronic pain of various etiologies seems very promising, but further studies need to be conducted. 2 r e v b r a s r e u m a t o l . 2 0 1 4;x x x(x x):xxx-xxx A ação analgésica da lidocaína intravenosa no tratamento da dor crônica: uma revisão de literatura Palavras-chave: Lidocaína Lidocaína intravenosa Dor crônica r e s u m o Justificativa: a dor é um problema de saúde pública, comprometendo sobremaneira a qualidade de vida. Quase 80% dos pacientes com dor crônica relataram que a dor interfere em suas atividades da vida diária, e dois terços afirmaram que a dor provoca impacto negativo nas relaç ões pessoais. A incapacidade física e funcional, seja temporária ou permanente, compromete a atividade profissional e causa absenteísmo ao trabalho, elevando os custos dos sistemas de saúde. Objetivos: o objetivo desta revisão é analisar, com base na literatura, o efeito analgésico da lidocaína administrada por via intravenosa no tratamento da dor crônica e avaliar a redução da intensidade da dor em pacientes com dor crônica, focando a etiologia musculoesquelética e neuropática. Metodologia: o método adotado foi o de revisão da literatura, consistindo na busca de artigos científicos sobre a eficácia da infusão intravenosa de lidoca...

Transforaminal Selective Epidural Block for Treating Dorsalgia due to Lumbar Compression Fracture

“…Then foraminae are the small lateral openings which the nerve roots traverse to exit the spinal canal. The benefits of then transforaminal approach, when performed by an experienced clinician, include decreased risk for dural puncture with delivery of smaller volumes of steroid to the appropriate site of considered pathology 3,10) .…”

“…Transforaminal epidural steroid Blocks (TFESB) is frequently performed to improve the symptoms of radiculopathy and low back pain which are usually observed in patients with spinal stenosis or herniated intervertebral discs 3) . This procedures is a useful for lumbar radiculopathy and the advantage of delivering highly concentrated medication to the poterior epidural space makes many pain physicians prefer the TFESB technique over an interlaminar or caudal approach.…”

Efektivitas Lidokain Intravena untuk Mengurangi Nyeri pada Pemberian Drip KCl melalui Akses Vena Perifer

“…Semua pasien yang masuk ke dalam kelompok perlakuan mengalami perbaikan kadar kalium setelah proses koreksi, sebagian besar pasien langsung mencapai kadar normokalemia, hanya sedikit pasien yang tidak mencapai normokalemia disebabkan karena pasien mengalami hipokalemia berat dan perlu memerlukan beberapa serial koreksi Penelitian sebelumnya menyebutkan jika pada nyeri-nyeri dengan intensitas yang lebih berat akan memerlukan pengaturan dosis dan akan memerlukan dosis yang lebih besar untuk dapat mengatasi nyeri. 25,26,27,28 Sehingga saat nyeri tetap muncul, klinisi perlu mengevaluasi dari dosis lidokain yang diberikan. Progresivitas nyeri yang dirasakan pasien, dapat ditanggulangi dengan menaikkan dosis lidokain yang diberikan.…”

“…29 Klinisi wajib memastikan dosis pemberian lidokain yang mampu menanggulangi nyeri tanpa mengesampingkan keamanan dari pemberian lidokain tersebut. 25,26 Progresivitas nyeri juga dipengaruhi oleh adanya komorbid dan riwayat penggunaan analgesia, dimana hal ini juga perlu untuk dievaluasi dalam manajemen nyeri pasien. Komorbid dan riwayat penggunaan analgesia sering berpengaruh terhadap ambang nyeri pasien.…”

Comparative Study between Intravenous Ketamine and Lidocaine Infusion in Controlling of Refractory Trigeminal Neuralgia

“…Lidocaine has been also used to relieve several types of neuropathic pain, including post herpetic neuralgia [4] and intractable TN [5,6]. This therapeutic effect is due to dose dependent sodium channels block [7,8] both peripherally and centrally [9].…”