Intravenous lidocaine in cancer-related neuropathic pain: case series

  • Danny Steven Castiblanco-Delgado a. Pain Medicine and Palliative Care, Universidad Militar Nueva Granada. Bogotá, Colombia. b. Pain Medicine and Palliative Care, Instituto Nacional de Cancerología. Bogotá, Colombia. http://orcid.org/0000-0001-5244-7056
  • Daniela Seija-Butnaru a. Pain Medicine and Palliative Care, Instituto Nacional de Cancerología. Bogotá, Colombia. b. Pain Medicine and Palliative Care, Universidad de La Sabana. Chía, Colombia.
  • Bilena Margarita Molina-Arteta Pain Medicine and Palliative Care, Instituto Nacional de Cancerología. Bogotá, Colombia. http://orcid.org/0000-0001-6468-3400
Keywords: Lidocaine, Intravenous infusion, Pain, Palliative care, Cancer

Abstract

Introduction: Administering systemic lidocaine has been shown to deliver effective analgesia for both cancer-related and non-cancer pain. Adverse effects and toxicity are rare with controlled administration.

Objective: To report the results obtained after the indication to manage with IV lidocaine infusion to control neuropathic pain flares in 9 cancer patients.

Methodology: Observational, descriptive, case series-type study. A search was conducted in the files of the Pain and Palliative Care Service of the National Cancer Institute - Instituto Nacional de Cancerología - in Bogotá. Patients over 18 years old diagnosed with cancer, who experienced high intensity neuropathic pain and with the cognitive ability to rate their pain in a numerical analogue scale (NAS), without any absolute contraindications for the use of IV lidocaine were included; patients were assessed between September 27 and November 21, 2019.

Results: 9 patients experiencing a pain flare-up which was characterized as neuropathic were registered, of which 89 % had some improvement following the administration of an initial lidocaine bolus. After one hour, 60 % reported over 40% improvement in the initial NAS. After 24 hours all patients had experienced some improvement, with a reduction of 46% in the pain scale as compared to the baseline.

Conclusions: In this series of cases, the intravenous infusion of lidocaine as an option for the management of neuropathic pain flares seems to reduce pain intensity following the initial bolus administration.

References

de Souza MF, Kraychete DC. A ação analgésica da lidocaína intravenosa no tratamento da dor crônica: uma revisão de literatura [The analgesic effect of intravenous lidocaine in the treatment of chronic pain: a literature review]. Rev Bras Reumatol. 2014;54(5):386-92. doi: http://www.doi.org/10.1016/j.rbr.2014.01.010

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(6):1738-49. doi: http://www.doi.org/10.1213/01.ANE.0000186348.86792.38

Kim YC, Castañeda AM, Lee CS, Jin HS, Park KS, Moon JY. Efficacy and safety of lidocaine infusion treatment for neuropathic pain: A randomized, double-blind, and placebo-controlled study. Reg Anesth Pain Med. 2018;43(4):415-24. doi: http://www.doi.org/10.1097/AAP.0000000000000741

Zhu B, Zhou X, Zhou Q, Wang H, Wang S, Luo K. Intra-venous lidocaine to relieve neuropathic pain: A systematic review and meta-analysis. Front Neurol. 2019;10:954. doi: http://www.doi.org/10.3389/fneur.2019.00954

Hutson P, Backonja M, Knurr H. Intravenous lidocaine for neuropathic pain: A retrospective analysis of tolerability and efficacy. Pain Medicine. 2015;16(3):531-6. doi: https://doi.org/10.1111/pme.12642

Buchanan DD, MacIvor F. A role for intravenous lidocaine in severe cancer-related neuropathic pain at the end-of-life. Support Care Cancer. 2010;18(7):899-901. doi: http://www.doi.org/10.1007/s00520-010-0864-3

Soto G, González MN, Calero F. Perfusión de lidocaína intravenosa. Rev Española Anest Rean. 2018;65(5):269-74. doi: http://www.doi.org/10.1016/j.redar.2018.01.004

Sharma S, Rajagopal MR, Palat G, Singh C, Haji AG, Jain D. A phase II pilot study to evaluate use of intravenous lidocaine for opioid-refractory pain in cancer patients. J Pain Symptom Manage. 2009;37(1):85-93. doi: http://www.doi.org/10.1016/j.jpainsymman.2007.12.023

Katzung B. Farmacología básica y clínica. 14th ed. McGraw-Hill Interamericana de España; 2013.

Quintana-Puerta JE, Cifuentes-Hoyos V. Toxicidad sistémica por anestésicos locales. Rev CES Med. 2014;28(1):107-18.

Ochoa-Anaya G, Aguirre-Ibarra CP, Franco-Cabrera M. Lidocaína: aspectos generales y nuevas implicaciones en la inflamación. Rev Mex Anest. 2017;40(3):220-5.

Lauretti GR. Mechanisms of analgesia of intravenous lidocaine. Rev Bras Anestesiol. 2008;58(3):280-6. doi: http://www.doi.org/10.1590/s0034-70942008000300011

Thomas J. Parenteral Lidocaine for Neuropathic Pain #180. J Palliative Med. 2009;12(2):188-90. doi: http://www.doi.org/10.1089/jpm.2009.9671

Ferrante FM, Paggioli J, Cherukuri S, Arthur GR. The analgesic response to intravenous lidocaine in the treatment of neuropathic pain. Anesth Analg. 1996;82(1):91-7. doi: http://www.doi.org/10.1097/00000539-199601000-00016

How to Cite
1.
Castiblanco-Delgado DS, Seija-Butnaru D, Molina-Arteta BM. Intravenous lidocaine in cancer-related neuropathic pain: case series. Colomb. J. Anesthesiol. [Internet]. 2021Sep.20 [cited 2021Oct.16];49. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/1004

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Published
2021-09-20
How to Cite
1.
Castiblanco-Delgado DS, Seija-Butnaru D, Molina-Arteta BM. Intravenous lidocaine in cancer-related neuropathic pain: case series. Colomb. J. Anesthesiol. [Internet]. 2021Sep.20 [cited 2021Oct.16];49. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/1004
Section
Case Report / Case Series

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