Parenteral lidocaine for treatment of intractable renal colic: a case series

Hassan Soleimanpour, Kamaleddin Hassanzadeh, Dawood Agha Mohammadi, Hassan Vaezi, Robab Mehdizadeh Esfanjani, Hassan Soleimanpour, Kamaleddin Hassanzadeh, Dawood Agha Mohammadi, Hassan Vaezi, Robab Mehdizadeh Esfanjani

Abstract

Introduction: We report a case series of successful treatment of intractable renal colic using parenteral lidocaine.

Case presentation: Because of inconsistent responses to standard treatment with opioids and non-steroidal anti-inflammatory drugs in patients with renal colic pain, we decided to begin a trial of a single intravenous dose of lidocaine (approximately 1.5 mg/kg) slowly in eight patients with intractable renal colic who were referred to our emergency medicine department. The patients were six men and two women with a mean age at diagnosis of 34.62 years (age range, 28 to 42 years). The patients were of Iranian ethnic origin. The patients' degree of pain, based on Visual Analog Scale score upon entering our emergency medicine department, was recorded 10, 20, and 30 minutes after lidocaine injection. The patients' degree of pain decreased from a mean Visual Analog Scale score (±SD) of 8.87 ± 0.99 (95% confidence interval (95% CI) 8.04 to 9.70) to a mean Visual Analog Scale score (±SD) of 1 ± 2.82 (95% CI -1.36 to 3.36) before and 30 minutes after lidocaine treatment, respectively. Two of eight patients experienced transient mild dizziness, and three of eight patients experienced minimal slurring of speech. No patient experienced serious adverse events.

Conclusion: Parenteral lidocaine treatment can reduce pain dramatically or subtly.

References

    1. Labrecque M, Dostaler LP, Rousselle R, Nguyen T, Poirier S. Efficacy of nonsteroidal anti-inflammatory drugs in the treatment of acute renal colic: a meta-analysis. Arch Intern Med. 1994;154:1381–1387. doi: 10.1001/archinte.154.12.1381.
    1. Ferrini R, Paice JA. How to initiate and monitor infusional lidocaine for severe and/or neuropathic pain. J Support Oncol. 2004;2:90–94.
    1. Wolff RF, Bala MM, Westwood M, Kessels AG, Kleijnen J. 5% lidocaine medicated plaster in painful diabetic peripheral neuropathy (DPN): a systematic review. Swiss Med Wkly. 2010;140:297–306.
    1. Schwartzman RJ, Patel M, Grothusen JR, Alexander GM. Efficacy of 5-day continuous lidocaine infusion for the treatment of refractory complex regional pain syndrome. Pain Med. 2009;10:401–412. doi: 10.1111/j.1526-4637.2009.00573.x.
    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. doi: 10.1213/ANE.0b013e3181be371b.
    1. Marx J, Hockberger R, Walls R. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7. Philadelphia: Mosby; 2010. pp. 1309–1311.
    1. Pervez A, Arif A. Role of ultrasound in evaluation of renal colic and assessment of risk factor for renal calculi. Gomal J Med Sci. 2007;5:22–27.
    1. Purohit RS, Stoller ML. In: Urological Emergencies: A Practical Guide. Wessells H, McAninch JW, editor. Totowa, NJ: Humana Press; 2005. Renal colic resulting from renal calculus disease; pp. 241–262.
    1. Rimbäck G, Cassuto J, Tollesson PO. Treatment of postoperative paralytic ileus by intravenous lidocaine infusion. Anesth Analg. 1990;70:414–419. doi: 10.1213/00000539-199002001-00414.

Source: PubMed

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