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Observational Study
. 2017:2017:8053474.
doi: 10.1155/2017/8053474. Epub 2017 Mar 28.

Intravenous Lidocaine: Old-School Drug, New Purpose-Reduction of Intractable Pain in Patients with Chemotherapy Induced Peripheral Neuropathy

Sandra A S van den Heuvel  1 , Selina E I van der Wal  1 , Lotte A Smedes  1 , Sandra A Radema  2 , Nens van Alfen  3 , Kris C P Vissers  1 , Monique A H Steegers  1
Affiliations
Observational Study

Intravenous Lidocaine: Old-School Drug, New Purpose-Reduction of Intractable Pain in Patients with Chemotherapy Induced Peripheral Neuropathy

Sandra A S van den Heuvel et al. Pain Res Manag. 2017.

Abstract

Background. Treatment of intractable pain due to chemotherapy induced peripheral neuropathy (CIPN) is a challenge. Intravenous (iv) lidocaine has shown to be a treatment option for neuropathic pain of different etiologies. Methods. Lidocaine (1.5 mg/kg in 10 minutes followed by 1.5 mg/kg/h over 5 hours) was administered in nine patients with CIPN, and analgesic effect was evaluated during infusion and after discharge. The immediate effect of lidocaine on pressure pain thresholds (PPT) and the extent of the stocking and glove distribution of sensory abnormalities (cold and pinprick) were assessed. Results. Lidocaine had a significant direct analgesic effect in 8 out of 9 patients (P = 0.01) with a pain intensity difference of >30%. Pain reduction persisted in 5 patients for an average of 23 days. Lidocaine did not influence mean PPT, but there was a tendency that the extent of sensory abnormalities decreased after lidocaine. Conclusion. Iv lidocaine has direct analgesic effect in CIPN with a moderate long-term effect and seems to influence the area of cold and pinprick perception. Additional research is needed, using a control group and larger sample sizes to confirm these results.

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Figures

Figure 1
Figure 1
Method of thermal and mechanical testing. (1) Distance between point of sensory change and digitus III before iv lidocaine. (2) Distance between point of sensory change and digitus III after iv lidocaine. Δ: change in distance before and after treatment with iv lidocaine.
Figure 2
Figure 2
Comparison of NRS scores of hands and feet during lidocaine infusion. Data are expressed as means.
See this image and copyright information in PMC

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