Lidocaine Infusion: A Promising Therapeutic Approach for Chronic Pain

Enas Kandil, Emily Melikman, Bryon Adinoff, Enas Kandil, Emily Melikman, Bryon Adinoff

Abstract

Opioid abuse is a national epidemic in the United States, where it is estimated that a prescription drug overdose death occurs every 19 minutes. While opioids are highly effective in acute and subacute pain control, their use for treatment of chronic pain is controversial. Chronic opioids use is associated with tolerance, dependency, hyperalgesia. Although there are new strategies and practice guidelines to reduce opioid dependence and opioid prescription drug overdose, there has been little focus on development of opioid-sparing therapeutic approaches. Lidocaine infusion has been shown to be successful in controlling pain where other agents have failed. The opioid sparing properties of lidocaine infusion added to its analgesic and antihyperalgesic properties make lidocaine infusion a viable option for pain control in opioid dependent patients. In this review, we provide an overview of the opioid abuse epidemic, and we outline current evidence supporting the potential use of lidocaine infusion as an adjuvant therapeutic approach for management of chronic pain.

Keywords: Choice of hospital; Hip replacement; Knee replacement; Patient expectations; Surgery.

Conflict of interest statement

Conflicts of Interest The authors do not have any conflicts of interest

Figures

Figure 1
Figure 1
Role of opioids in development of central sensitization.
Figure 2
Figure 2
Role of lidocaine in prevention of central sensitization.

References

    1. Martell BA, O’Connor PG, Kerns RD, Becker WC, Morales KH, et al. Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction. Ann Intern Med. 2007;146:116–127.
    1. Slomski A. Cultural transformation needed to solve public health problem of chronic pain. JAMA. 2011;306:692–693.
    1. Turk DC. Pain Terms and Taxomonies. 3 2001.
    1. Lippe PM, Brock C, David J, Crossno R, Gitlow S. The First National Pain Medicine Summit--final summary report. Pain Med. 2010;11:1447–1468.
    1. Verhaak PF, Kerssens JJ, Dekker J, Sorbi MJ, Bensing JM. Prevalence of chronic benign pain disorder among adults: a review of the literature. Pain. 1998;77:231–239.
    1. Nicholson B. Responsible prescribing of opioids for the management of chronic pain. Drugs. 2003;63:17–32.
    1. Goodman FD, Glassman P. Evaluating potentially aberrant outpatient prescriptions for extended-release oxycodone. Am J Health Syst Pharm. 2005;62:2604–2608.
    1. Olsen Y, Daumit GL, Ford DE. Opioid prescriptions by U.S. primary care physicians from 1992 to 2001. J Pain. 2006;7:225–235.
    1. Zerzan JT, Morden NE, Soumerai S, Ross-Degnan D, Roughead E, et al. Trends and geographic variation of opiate medication use in state Medicaid fee-for-service programs, 1996 to 2002. Med Care. 2006;44:1005–1010.
    1. Joranson DE, Gilson AM. Drug crime is a source of abused pain medications in the United States. J Pain Symptom Manag. 2005;30:299–301.
    1. Trescot AM, Datta S, Lee M, Hansen H. Opioid pharmacology. Pain Physician. 2008;11:S133–153.
    1. Compton WM, Volkow ND. Abuse of prescription drugs and the risk of addiction. Drug Alcohol Depend. 2006;83(l1):4–7.
    1. Compton WM, Volkow ND. Major increases in opioid analgesic abuse in the United States: concerns and strategies. Drug Alcohol Depend. 2006;81:103–107.
    1. Bohnert AS, Valenstein M, Bair MJ, Ganoczy D, McCarthy JF, et al. Association between opioid prescribing patterns and opioid overdose-related deaths. JAMA. 2011;305:1315–1321.
    1. Warner M, Chen LH, Makuc DM. Increase in fatal poisonings involving opioid analgesics in the United States, 1999–2006. NCHS Data Brief. 2009;22:1–8.
    1. Okie S. A flood of opioids, a rising tide of deaths. N Engl J Med. 2010;363:1981–1985.
    1. Dobscha SK, Corson K, Flores JA, Tansill EC, Gerrity MS. Veterans affairs primary care clinicians’ attitudes toward chronic pain and correlates of opioid prescribing rates. Pain Med. 2008;9:564–571.
    1. Ballantyne JC, Mao J. Opioid therapy for chronic pain. N Engl J Med. 2003;349:1943–1953.
    1. Eriksen J. Opioids in chronic non-malignant pain. Eur J Pain. 2001;5:231–232.
    1. Grunkemeier DM, Cassara JE, Dalton CB, Drossman DA. The narcotic bowel syndrome: clinical features, pathophysiology, and management. Clin Gastroenterol Hepatol. 2007;5:1126–1122.
    1. Vuong C, Van Uum SH, O’Dell LE, Lutfy K, Friedman TC. The effects of opioids and opioid analogs on animal and human endocrine systems. Endocr Rev. 2010;31:98–132.
    1. Benyamin R, Trescot AM, Datta S, Buenaventura R, Adlaka R, et al. Opioid complications and side effects. Pain Physician. 2008;11:S105–120.
    1. Roy S, Loh HH. Effects of opioids on the immune system. Neurochem Res. 1996;21:1375–1386.
    1. Wick MJ, Minnerath SR, Roy S, Ramakrishnan S, Loh HH. Differential expression of opioid receptor genes in human lymphoid cell lines and peripheral blood lymphocytes. J Neuroimmunol. 1996;64:29–36.
    1. Sacerdote P, Franchi S, Panerai AE. Non-analgesic effects of opioids: mechanisms and potential clinical relevance of opioid-induced immunodepression. Curr Pharm Des. 2012;18:6034–6042.
    1. Dublin S, Walker RL, Jackson ML, Nelson JC, Weiss NS, et al. Use of opioids or benzodiazepines and risk of pneumonia in older adults: a population-based case-control study. J Am Geriatr Soc. 2011;59:1899–1907.
    1. Hu P, McLachlan EM. Macrophage and lymphocyte invasion of dorsal root ganglia after peripheral nerve lesions in the rat. Neuroscience. 2002;112:23–38.
    1. Sommer C, Kress M. Recent findings on how proinflammatory cytokines cause pain: peripheral mechanisms in inflammatory and neuropathic hyperalgesia. Neurosci Lett. 2004;361:184–187.
    1. Liang D, Shi X, Qiao Y, Angst MS, Yeomans DC, et al. Chronic morphine administration enhances nociceptive sensitivity and local cytokine production after incision. Mol Pain. 2008;4:7.
    1. Gordon RA. Intravenous Novocaine for Analgesia in Burns: (A Preliminary Report) Can Med Assoc J. 1943;49:478–481.
    1. Vigneault L, Turgeon AF, Côté D, Lauzier F, Zarychanski R, et al. Perioperative intravenous lidocaine infusion for postoperative pain control: a meta-analysis of randomized controlled trials. Can J Anaesth. 2011;58:22–37.
    1. Backonja M. Neuromodulating drugs for the symptomatic treatment of neuropathic pain. Curr Pain Headache Rep. 2004;8:212–216.
    1. Rogers M, Tang L, Madge DJ, Stevens EB. The role of sodium channels in neuropathic pain. Semin Cell Dev Biol. 2006;17:571–581.
    1. Hollmann MW, Durieux ME. Local anesthetics and the inflammatory response: a new therapeutic indication? Anesthesiology. 2000;93:858–875.
    1. Cassuto J, Sinclair R, Bonderovic M. Anti-inflammatory properties of local anesthetics and their present and potential clinical implications. Acta Anaesthesiol Scand. 2006;50:265–282.
    1. Koppert W, Ostermeier N, Sittl R, Weidner C, Schmelz M. Low-dose lidocaine reduces secondary hyperalgesia by a central mode of action. Pain. 2000;85:217–224.
    1. Wallace MS, Ridgeway BM, Leung AY, Gerayli A, Yaksh TL. Concentration-effect relationship of intravenous lidocaine on the allodynia of complex regional pain syndrome types I and II. Anesthesiology. 2000;92:75–83.
    1. Attal N, Gaudé V, Brasseur L, Dupuy M, Guirimand F, et al. Intravenous lidocaine in central pain: a double-blind, placebo-controlled, psychophysical study. Neurology. 2000;54:564–574.
    1. Attal N, Rouaud J, Brasseur L, Chauvin M, Bouhassira D. Systemic lidocaine in pain due to peripheral nerve injury and predictors of response. Neurology. 2004;62:218–225.
    1. Tremont-Lukats IW, Challapalli V, McNicol ED, Lau J, Carr DB. Systemic administration of local anesthetics to relieve neuropathic pain: a systematic review and meta-analysis. Anesth Analg. 2005;101:1738–1749.
    1. Gottrup H, Bach FW, Juhl G, Jensen TS. Differential effect of ketamine and lidocaine on spontaneous and mechanical evoked pain in patients with nerve injury pain. Anesthesiology. 2006;104:527–536.
    1. Finnerup NB, Biering-Sørensen F, Johannesen IL, Terkelsen AJ, Juhl GI, et al. Intravenous lidocaine relieves spinal cord injury pain: a randomized controlled trial. Anesthesiology. 2005;102:1023–1030.
    1. Viola V, Newnham HH, Simpson RW. Treatment of intractable painful diabetic neuropathy with intravenous lignocaine. J Diabetes Compl. 2006;20:34–39.
    1. Carroll I, Gaeta R, Mackey S. Multivariate analysis of chronic pain patients undergoing lidocaine infusions: increasing pain severity and advancing age predict likelihood of clinically meaningful analgesia. Clin J Pain. 2007;23:702–706.
    1. Schafranski MD, Malucelli T, Machado F, Takeshi H, Kaiber F, et al. Intravenous lidocaine for fibromyalgia syndrome: an open trial. Clin Rheumatol. 2009;28:853–855.
    1. Park CH, Jung SH, Han CG. Effect of intravenous lidocaine on the neuropathic pain of failed back surgery syndrome. Korean J Pain. 2012;25:94–98.
    1. Tanen DA, Shimada M, Danish DC, Dos Santos F, Makela M, et al. Intravenous lidocaine for the emergency department treatment of acute radicular low back pain, a randomized controlled trial. J Emerg Med. 2014;47:119–124.
    1. Gormsen L, Finnerup NB, Almqvist PM, Jensen TS. The efficacy of the AMPA receptor antagonist NS1209 and lidocaine in nerve injury pain: a randomized, double-blind, placebo-controlled, three-way crossover study. Anesth Analg. 2009;108:1311–1319.
    1. Kvarnström A, Karlsten R, Quiding H, Emanuelsson BM, Gordh T. The effectiveness of intravenous ketamine and lidocaine on peripheral neuropathic pain. Acta Anaesthesiol Scand. 2003;47:868–877.
    1. Kvarnström A, Karlsten R, Quiding H, Gordh T. The analgesic effect of intravenous ketamine and lidocaine on pain after spinal cord injury. Acta Anaesthesiol Scand. 2004;48:498–506.
    1. Lemming D, Sorensen J, Graven-Nielsen T, Arendt-Nielsen L, Gerdle B. The responses to pharmacological challenges and experimental pain in patients with chronic whiplash-associated pain. Clin J Pain. 2005;21:412–421.
    1. Schipper S, Gantenbein AR, Maurer K, Alon E, Sándor PS. Predictive value of lidocaine for treatment success of oxcarbazepine in patients with neuropathic pain syndrome. Pain Ther. 2013;2:49–56.
    1. Tremont-Lukats IW, Hutson PR, Backonja MM. A randomized, double-masked, placebo-controlled pilot trial of extended IV lidocaine infusion for relief of ongoing neuropathic pain. Clin J Pain. 2006;22:266–271.
    1. Wu CL, Tella P, Staats PS, Vaslav R, Kazim DA, et al. Analgesic effects of intravenous lidocaine and morphine on postamputation pain: a randomized double-blind, active placebo-controlled, crossover trial. Anesthesiology. 2002;96:841–848.
    1. Keats AS, D’Alessandro GL, Beecher HK. Controlled study of pain relief by intravenous procaine. JAMA. 1951;147:1761–1763.
    1. Bartlett EE, Hutserani O. Xylocaine for the relief of postoperative pain. Anesth Analg. 1961;40:296–304.
    1. Gilbert CR, Hanson IR, Brown AB, Hingson RA. Intravenous use of xylocaine. Curr Res Anesth Analg. 1951;30:301–313.
    1. Nagy I, Woolf CJ. Lignocaine selectively reduces C fibre-evoked neuronal activity in rat spinal cord in vitro by decreasing N-methyl-D-aspartate and neurokinin receptor-mediated post-synaptic depolarizations; implications for the development of novel centrally acting analgesics. Pain. 1996;64:59–70.
    1. Chabal C, Russell LC, Burchiel KJ. The effect of intravenous lidocaine, tocainide, and mexiletine on spontaneously active fibers originating in rat sciatic neuromas. Pain. 1989;38:333–338.
    1. 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.
    1. Cassuto J, Wallin G, Högström S, Faxén A, Rimbäck G. Inhibition of postoperative pain by continuous low-dose intravenous infusion of lidocaine. Anesth Analg. 1985;64:971–974.
    1. Groudine SB, Fisher HA, Kaufman RP, Jr, Patel MK, Wilkins LJ, et al. Intravenous lidocaine speeds the return of bowel function, decreases postoperative pain, and shortens hospital stay in patients undergoing radical retropubic prostatectomy. Anesth Analg. 1998;86:235–239.
    1. Harvey KP, Adair JD, Isho M, Robinson R. Can intravenous lidocaine decrease postsurgical ileus and shorten hospital stay in elective bowel surgery? A pilot study and literature review. Am J Surg. 2009;198:231–236.
    1. Herroeder S, Pecher S, Schönherr ME, Kaulitz G, Hahnenkamp K, et al. Systemic lidocaine shortens length of hospital stay after colorectal surgery: a double-blinded, randomized, placebo-controlled trial. Ann Surg. 2007;246:192–200.
    1. Ness TJ. Intravenous lidocaine inhibits visceral nociceptive reflexes and spinal neurons in the rat. Anesthesiology. 2000;92:1685–1691.
    1. McCarthy GC, Megalla SA, Habib AS. Impact of intravenous lidocaine infusion on postoperative analgesia and recovery from surgery: a systematic review of randomized controlled trials. Drugs. 2010;70:1149–1163.
    1. Koppert W, Weigand M, Neumann F, Sittl R, Schuettler J, et al. Perioperative intravenous lidocaine has preventive effects on postoperative pain and morphine consumption after major abdominal surgery. Anesth Analg. 2004;98:1050–1055.
    1. Baral BK, Bhattarai BK, Rahman TR, Singh SN, Regmi R. Perioperative intravenous lidocaine infusion on postoperative pain relief in patients undergoing upper abdominal surgery. Nepal Med Coll J. 2010;12:215–220.
    1. Bryson GL, Charapov I, Krolczyk G, Taljaard M, Reid D. Intravenous lidocaine does not reduce length of hospital stay following abdominal hysterectomy. Can J Anaesth. 2010;57:759–766.
    1. Cui W, Li Y, Li S, Wang R, Li J. Systemic administration of lidocaine reduces morphine requirements and postoperative pain of patients undergoing thoracic surgery after propofol-remifentanil-based anaesthesia. Eur J Anaesthesiol. 2010;27:41–46.
    1. De Oliveira GS, Fitzgerald P, Streicher LF, Marcus RJ, McCarthy RJ. Systemic lidocaine to improve postoperative quality of recovery after ambulatory laparoscopic surgery. Anesth Analg. 2012;115:262–267.
    1. El-Tahan MR, Warda OM, Diab DG, Ramzy EA, Matter MK. A randomized study of the effects of perioperative i.v. lidocaine on hemodynamic and hormonal responses for cesarean section. J Anesthesia. 2009;23:215–221.
    1. Farag E, Ghobrial M, Sessler DI, Dalton JE, Liu J, et al. Effect of perioperative intravenous lidocaine administration on pain, opioid consumption, and quality of life after complex spine surgery. Anesthesiology. 2013;119:932–940.
    1. Grady P, Clark N, Lenahan J, Oudekerk C, Hawkins R, Nezat G, et al. Effect of intraoperative intravenous lidocaine on postoperative pain and return of bowel function after laparoscopic abdominal gynecologic procedures. AANA J. 2012;80:282–288.
    1. Grigoras A, Lee P, Sattar F, Shorten G. Perioperative intravenous lidocaine decreases the incidence of persistent pain after breast surgery. Clin J Pain. 2012;28:567–572.
    1. Kaba A, Laurent SR, Detroz BJ, Sessler DI, Durieux ME, et al. Intravenous lidocaine infusion facilitates acute rehabilitation after laparoscopic colectomy. Anesthesiology. 2007;106:11–18.
    1. Kim KT, Cho DC, Sung JK, Kim YB, Kang H, et al. Intraoperative systemic infusion of lidocaine reduces postoperative pain after lumbar surgery: a double-blinded, randomized, placebo-controlled clinical trial. Spine J. 2014;14:1559–1566.
    1. Lauwick S, Kim DJ, Michelagnoli G, Mistraletti G, Feldman L, et al. Intraoperative infusion of lidocaine reduces postoperative fentanyl requirements in patients undergoing laparoscopic cholecystectomy. Can J Anaesth. 2008;55:754–760.
    1. Martin F, Cherif K, Gentili ME, Enel D, Abe E, et al. Lack of impact of intravenous lidocaine on analgesia, functional recovery, and nociceptive pain threshold after total hip arthroplasty. Anesthesiology. 2008;109:118–123.
    1. Tauzin-Fin P, Bernard O, Sesay M, Biais M, Richebe P, et al. Benefits of intravenous lidocaine on post-operative pain and acute rehabilitation after laparoscopic nephrectomy. J Anaesthesiol Clin Pharmacol. 2014;30:366–372.
    1. Wasiak J, Spinks A, Costello V, Ferraro F, Paul E, et al. Adjuvant use of intravenous lidocaine for procedural burn pain relief: a randomized double-blind, placebo-controlled, cross-over trial. Burns. 2011;37:951–957.
    1. Wongyingsinn M, Baldini G, Charlebois P, Liberman S, Stein B, et al. Intravenous lidocaine versus thoracic epidural analgesia: a randomized controlled trial in patients undergoing laparoscopic colorectal surgery using an enhanced recovery program. Reg Anesth Pain Med. 2011;36:241–248.
    1. Wuethrich PY, Romero J, Burkhard FC, Curatolo M. No benefit from perioperative intravenous lidocaine in laparoscopic renal surgery: a randomised, placebo-controlled study. Eur J Anaesthesiol. 2012;29:537–543.
    1. Yardeni IZ, Beilin B, Mayburd E, Levinson Y, Bessler H. The effect of perioperative intravenous lidocaine on postoperative pain and immune function. Anesth Analg. 2009;109:1464–1469.
    1. Zengin SU, Saracoglu A, Eti Z, Umuroglu T, Gogus FY. The effects of preoperative oral pregabalin and perioperative intravenous lidocaine infusion on postoperative morphine requirement in patients undergoing laparatomy. Pain Res Manag. 2015;20:179–182.
    1. Kang H, Kim BG. Intravenous lidocaine for effective pain relief after inguinal herniorrhaphy: a prospective, randomized, double-blind, placebo-controlled study. J Int Med Res. 2011;39:435–445.
    1. Kuo CP, Jao SW, Chen KM, Wong CS, Yeh CC, et al. Comparison of the effects of thoracic epidural analgesia and i.v. infusion with lidocaine on cytokine response, postoperative pain and bowel function in patients undergoing colonic surgery. Br J Anaesth. 2006;97:640–646.
    1. McKay A, Gottschalk A, Ploppa A, Durieux ME, Groves DS. Systemic lidocaine decreased the perioperative opioid analgesic requirements but failed to reduce discharge time after ambulatory surgery. Anesth Analg. 2009;109:1805–1808.
    1. Wu CT, Borel CO, Lee MS, Yu JC, Liou HS, et al. The interaction effect of perioperative cotreatment with dextromethorphan and intravenous lidocaine on pain relief and recovery of bowel function after laparoscopic cholecystectomy. Anesth Analg. 100:448–453.
    1. van den Beuken-van Everdingen MH, de Rijke JM, Kessels AG, Schouten HC, van Kleef M, et al. Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol. 2007;18:1437–1449.
    1. Massey GV, Pedigo S, Dunn NL, Grossman NJ, Russell EC. Continuous lidocaine infusion for the relief of refractory malignant pain in a terminally ill pediatric cancer patient. J Pediatr Oncol. 2002;24:566–568.
    1. Kajiume T, Sera Y, Nakanuno R, Ogura T, Karakawa S, et al. Continuous intravenous infusion of ketamine and lidocaine as adjuvant analgesics in a 5-year-old patient with neuropathic cancer pain. J Palliat Med. 2012;15:719–722.
    1. Sharma S, Rajagopal MR, Palat G, Singh C, Haji AG, et al. A phase II pilot study to evaluate use of intravenous lidocaine for opioid-refractory pain in cancer patients. J Pain Symptom Manage. 2009;37:85–93.
    1. McCleane G. Intravenous lidocaine: an outdated or underutilized treatment for pain? J Palliat Med. 2007;10:798–805.
    1. Tei Y, Morita T, Shishido H, Inoue S. Lidocaine intoxication at very small doses in terminally ill cancer patients. J Pain Symptom Manage. 2005;30:6–7.
    1. Thomas J, Kronenberg R, Cox MC, Naco GC, Wallace M, et al. Intravenous lidocaine relieves severe pain: results of an inpatient hospice chart review. J Palliat Med. 2004;7:660–667.
    1. Buchanan DD, MacIvor JF. A role for intravenous lidocaine in severe cancer-related neuropathic pain at the end-of-life. Support Care Cancer. 2010;18:899–901.
    1. Ferrini R. Parenteral lidocaine for severe intractable pain in six hospice patients continued at home. J Palliat Med. 2000;3:193–200.

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit