Hello all,

I recently had a discussion with an anesthesiologist regarding my PN pain. (I am not a diabetic nor has any other reason been found for my PN so I have been an Idiopathic sufferer for about 4 yrs.)

He asked if I had ever heard of lidocaine infusions for the treatment of PN pain. I had not and so I thought I would bring it here. Has anyone been treated with lidocaine infusions for PN?

Thanks,
Nancy-H

Just did a search on it and the only thing that gives me 'cause for pause' is that there really isn't anything very 'current' on it as a therapy. Most of the research seems to be in small focus specific groups.

WHY hasn't it caught on? would be my big question.... I also feel that it's interesting that your pain doc would stretch and be, essentially, experimental. It's an aspect that can be good or bad.

It it were me? I'd really read the fine print about s/e's of lido infusions in all findable instances and maybe give it a try. I hesitate because when I use patches things go VERY dead and there are times the trade-off is worth it and others when it's not.

Whatever your decision, I for one, am awaiting for what all happens! - j

went through my mind. This is not something he was suggesting that I try at this point in the game but something that he had discussed with a doc at a pain convention. Waaaaay more info needs to come to me before I connect to a drip :-)

There is one machine that they have at the hospital here, which is new and so all the equipment is new. But, dummy me misplaced the brochure so I don't have the correct name to share. It's like a big TENS unit. Anyone heard of such a machine?

My pain has increased something terrible lately and I've not done anything to bring it on. It starts at bedtime and goes until about 3 a.m. or all day the following day. I know you guys are no strangers to pain but this has been going on now 3 weeks. How long do your pain flares last???

My best to all,
Nancy-H

Here's some of what the information says:

"Lidocaine Infusion
Intravenous lidocaine infusion is occasionally administered for diagnostic purposes. A "lidocaine test" may be given in patients with suspected neuropathic pain to predict response to oral mexiletine.[24] If the pain is neuropathic, transient pain relief may occur, lasting for several hours.[24] One study of a small number of patients reported pain relief lasting days to weeks after a lidocaine infusion.[24] Electrocardiogram and blood pressure monitoring are required during continuous infusion of lidocaine, and resusci-tative equipment must be readily accessible.[24]
Contraindications to therapy are hyper-sensitivity to amide-type local anesthetics, Adams-Strokes syndrome, and high-grade heart block.[24] Adverse effects are dosage related and transient. They include paresthesias of the fingers, abnormal taste, tinnitus, blurred vision, drowsiness, and dysarthria.[24] Higher dosages of lidocaine may cause cardiac arrhythmias and seizures. If the patient experiences drowsiness or dysarthria, the infusion should be discontinued immediately.[24] To administer lidocaine intravenously, a dose of 5 mg/kg of body weight should be infused over 30-45 minutes.[24, 41]

Continuous subcutaneous lidocaine infusion may be useful for the management of neuro-pathic pain states. Such use should be under the direction of a pain management specialist."

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Now, I can't tell you how many times I have asked neuros, pain management docs, everybody who wears a white coat, I have asked the following:

"Why can't they just take an injection of Lidocaine and stick it where it hurts (like with Alan, it's between certain toes of each foot, and it drives HIM CRAZY, SOMETIMES") Well, you should see the look the docs give me, a look like "what is she nuts, or something??"

And now I hear about something called a lidocaine infusion. You know, I wonder if they can mix it in with his IVIG, I mean, once they start doing it???

Interesting stuff.

Mel

I have not had regular Lidocaine infusions, but I did have Lidocaine in my IV, when my gallbladder was removed. It was WONDERFUL... I saw a pain management doctor not long after that who was going to try me on this, probably as Melody said, to see if I was a candidate for Mexiletine.

My Neurologist said "ABSOLUTELY NOT." I cannot recall why he was so definite about this..

I do get trigger point injections with Lidocaine and a little Cortisone, which helps in the places that hurt. It is not permanent, but in my case has been a Godsend at times. It varies on how long it lasts. I was leary at first about having this, because an old doc injected my back with this once, and it hurt like the devil-probably because the needle was huge. This doc uses a very fine needle and deadens as he begins. You hardly know you are being stuck... He also does the epidural, which helped considerably with the lower back.

Cathie

Every time I asked a doctor, I was told "No, it's not possible"!!!

And now I hear that you have gotten them!!!

What is wrong with these docs???

Melody

So it isn't just my imagination. There are times when the pain is worse than others. Nights when it's hardly noticeable and others where I'm going crazy. I'm not sure what causes this for me. Increased stress perhaps? Whatever it is it's really aggravating never knowing what to expect til I actually get into bed for a bit.

I have severe fibromyalgia and a pinched nerve in my lower back. I have been treating with a pain specialist for 6 years. He is great! I take methadone and oxycodone for pain. My regular doctor prescribed 5% lidocaine ointment for topical use several months ago. It works very well. I told my pain doctor about it and he suggested that I have lidocaine infusions. So, I had the first one today. It hasn't done anything so far. It did make me feel "out of it". Luckily, my daughter went with me, so she could drive me home in case that happened. I guess these infusions work for approximately 2 weeks. I guess I will have to wait and see. I saw where others said that it was not very good, etc. I don't know. I just thought I would put my 2 cents in.

I hope you get some relief from the infusion, I have been getting them for over a year now and although they don't take the pain away completely they give me lots of good days. I am always out of it for a few days afterwards, although I am so tired by the time I get them that maybe it is just sheer exhaustion. The first three days I still get pain but it is only on the surface of the skin, it burns immensely and then the pain lessens.
My pain doc has seen patients whose pain has gradually disappeared and I can say one foot(which used to be my worst is now a lot better than the other).
Remember not to overdo it too much when you do feel good as the pain can come back with a vengeance, I wrote a sort of blog last year if you want to read it just look at my old threads.
I get around 3-4 weeks relief now but only have the infusions every6-8 weeks which is a living nghtmare as you know there is a treatment but in the UK I can't get access to this.

If the lidocaine ointment works, why not try the patches called Lidoderm? They are less invasive than an infusion.
I've used Lidoderm for years. They are very nice.