Purpose of Technology: Lidocaine hydrochloride is a local anesthetic with antiarrhythmic properties that may hold utility in the treatment of select patients with intractable neuropathic pain. Intravenous lidocaine helps to suppress spontaneous ectopic discharges of damaged nerves without blocking normal neuronal conduction, which in part underlies its analgesic effect.

Rationale: Opioid prescriptions have increased dramatically in use over the past 2 decades, and opioid use disorder is now a major health problem in the United States. Opioids are partially effective for pain relief in the short-term and highly variable for long-term pain, and their chronic use is associated with tolerance, dependency, and hyperalgesia. However, development of alternative, effective treatments has been limited, and other treatment options for patients with neuropathic pain are limited.

Controversy: There is no standard treatment protocol for the use of intravenous lidocaine infusions for neuropathic pain, and its effectiveness for treating neuropathic pain has not been firmly established.

Relevant Questions:

  • Does intravenous lidocaine effectively reduce pain intensity in patients with neuropathic pain of varying etiologies?
  • Is intravenous lidocaine safe?
  • Have definitive patient selection criteria been established?

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