Pain medicine Terapia 2023, 6 ( 425 ) : 18 - 23
Intravenous infusions of lidocaine in patients with neuropathic pain
Summary:
Lidocaine is a local anesthetic and antiarrhythmic agent with an amide structure. It has been widely used for years in the treatment of acute pain and regional analgesia. A novelty in pain medicine are the new registration indications for Lignocainum hydrochloricum WZF 1% and 2%, 10 mg/ml and 20 mg/ml, solution for injection, including the treatment of neuropathic pain as a second-line drug. One of the key pathomechanisms of neuropathic pain is the pathology of sodium channels, which contributes to peripheral and central sensitization, allodynia, hyperalgesia, spontaneous and induced pain. Experimental and clinical studies have shown that lidocaine blocks ectopic activity within the damaged nerve and blocks pathological sodium channels in the peripheral and central nervous system. It also acts on other receptors and ion channels involved in pathological nociception, and has an anti-inflammatory effect. The analgesic effect of lidocaine in intravenous infusions has been observed in patients with diabetic neuropathy, postherpetic neuralgia, trigeminal neuralgia, peripheral polyneuropathy of various etiologies, pain after amputation, in complex local pain syndrome, in central pain after spinal cord injury and stroke. The recommended use of lidocaine in an intravenous infusion is a dose of 3-5 mg/kg bw, infused over a minimum of 30 minutes, once a day, in a hospital or pain clinic, with monitoring of the patient's condition. The most common side effects observed during intravenous infusions are in more than 20% of patients - drowsiness, fatigue, weakness, dizziness, speech disorders, memory disorders. Serious side effects, arrhythmias and haemodynamic instability were not observed.
Keywords: neuropathic pain, lidocaine, pain treatment
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