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Intravenous infusion of lidocaine enhances the efficacy of conventional treatment of postherpetic neuralgia

Authors Tan X, Ma L, Yuan J, Zhang D, Wang J, Zhou W, Cao S

Received 23 April 2019

Accepted for publication 6 August 2019

Published 20 August 2019 Volume 2019:12 Pages 2537—2545


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr E Alfonso Romero-Sandoval

Xinran Tan,1 Lulin Ma,1 Jie Yuan,1,2 Dexin Zhang,1 Jie Wang,1 Wenjing Zhou,2 Song Cao1,2

1Department of Pain Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, People’s Republic of China; 2Guizhou Key Laboratory of Anesthesia and Organ Protection, Zunyi Medical University, Zunyi 563000, People’s Republic of China

Correspondence: Song Cao
Department of Pain Medicine, Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Zunyi 563000, Guizhou, People’s Republic of China
Tel +86 1 821 217 0434

Background: Postherpetic neuralgia (PHN) is one kind of severe neuropathic pain which currently cannot be effectively cured. Recent researches suggest that intravenous infusion of lidocaine has a therapeutic effect on neuropathic pain such as PHN; however, the optimal dose and frequency of lidocaine infusion and the effectiveness and safety of this treatment in PHN patients still needs more clinical research. The aim of this study was to evaluate the therapeutic effects of daily intravenous lidocaine infusion on the outcome of the routine treatment of PHN.
Methods: Sixty PHN patients were randomly divided into two groups: 1) control group (Control), treated with conventional therapies, such as antiepileptic pills, analgesics, neurotrophic medicines, paravertebral spinal nerve block and physiotherapy; 2) lidocaine group (Lido) received daily infusion of lidocaine (4 mg/kg) besides the conventional treatments. If the pain is not controlled sufficiently, additional tramadol is given and the average consumption of tramadol is calculated. Pain intensity was assessed before and after each infusion, and the number of breakthrough pain in the last 24 hrs were recorded. The incidence of adverse reactions related to intravenous lidocaine infusion was recorded.
Results: For five consecutive days, numeric rating scale (NRS) scores were significantly decreased after 1 hr of intravenous infusion of lidocaine. Compared with Control, the NRS scores and the frequency of breakthrough pain in the Lido were significantly reduced. In addition, the extra tramadol consumption in the Lido was significantly lower than that in the Control, and the average hospital stay of patients in Lido was decreased. However, anxiety and depression scores showed no difference between Lido and Control.
Conclusion: Daily intravenous lidocaine (4 mg/kg for 5 days) enhanced the outcome of PHN treatment, reduced the amount of analgesic medicine and shortened the length of hospital stay with no obvious adverse side effects.

Keywords: postherpetic neuralgia, lidocaine, pain, intravenous infusion

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