section name header

Evidence summaries

Systemic Administration of Local Anesthetics to Relieve Neuropathic Pain

Intravenous lidocaine and its oral derivatives are effective and safe drugs for neuropathic pain. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 32 studies. The treatment drugs were intravenous lidocaine (16 trials), mexiletine (12 trials), lidocaine plus mexiletine sequentially (one trial), and tocainide (one trial). Twenty-one trials were crossover studies, and nine were parallel. Lidocaine and mexiletine were superior to placebo [weighted mean difference (WMD) = -11; 95% CI: -15 to -7; P <0.00001], and limited data showed no difference in efficacy (WMD = -0.6; 95% CI: -7 to 6), or adverse effects versus carbamazepine, amantadine, gabapentin or morphine. In these trials, systemic local anesthetics were safe, with no deaths or life-threatening toxicities.

    References

    • Challapalli V, Tremont-Lukats IW, McNicol ED, Lau J, Carr DB. Systemic administration of local anesthetic agents to relieve neuropathic pain. Cochrane Database Syst Rev 2005 Oct 19;(4):CD003345. [PubMed]

Primary/Secondary Keywords