The Effect of Intravenous Lidocaine on Post Herpetic Neuralgia in Palliative Care Unit: A Randomized Double Blind Placebo Controlled Trial
Keywords:
Post Herpetic Neuralgia, Herpes zoster, Lidocaine, Allodynia, HyperalgesiaAbstract
Introduction: Post herpetic neuralgia (PHN) is a painful complication of herpes zoster (shingles). Its therapeutic approach is challenging as the first line treatment often does not help and may cause intolerable side effects. The aim of our randomized double blind, placebo controlled, crossover study was to investigate in a prospective way the effect of intravenous lidocaine in patients with post herpetic neuralgia in palliative care unit. Material and Method: Twenty patients met our inclusion criteria and completed the study. Each patient underwent four weekly sessions, two of which were with lidocaine (5 mgs/kg) and two with placebo infusions administered over 60 minutes. Results: Intravenous lidocaine was superior regarding the reduction of the intensity of pain, the allodynia, and the hyperalgesia compared to placebo. Also contrary to placebo, lidocaine managed to maintain its therapeutic results for the first 24 hours after intravenous infusion. Discussion: Although, intravenous lidocaine is not a first line treatment, when first line medications fail to help, pain specialists may try it as an add-on treatment.
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