Intravenous lidocaine, amantadine, and placebo in the treatment of sciatica: a double-blind, randomized, controlled study

Reg Anesth Pain Med. 1999 Nov-Dec;24(6):534-40. doi: 10.1016/s1098-7339(99)90045-7.


Background and objectives: Sciatica is a neuropathic pain syndrome caused by compression and/or inflammation of spinal nerve roots by herniated disc material, and its treatment is therefore usually aimed at reducing compression and inflammation. Studies have shown that both systemic local anesthetics and N-methyl-D-aspartate (NMDA) receptor antagonists may produce analgesia in a variety of neuropathic pain syndromes. The present study evaluated the analgesic efficacy of i.v. infusions of the local anesthetic lidocaine, the NMDA receptor antagonist amantadine, and a placebo in sciatica.

Methods: Thirty patients with sciatica, as confirmed by physical examination and imaging studies, were enrolled in a randomized, double-blind, three-arm crossover trial. Infusions of amantadine (2.5 mg/kg), lidocaine (5 mg/kg), and a placebo were administered over a 2-hour period, 2-7 days apart from each other. Spontaneous pain (visual analog scale) and evoked pain (straight leg raise) were measured every 30 minutes for 3 hours.

Results: Lidocaine reduced spontaneous pain as compared with amantadine and with the placebo for all measurements and at a significant level at the 30 (P < .05), 120, and 180 (P < .01) minute time points. Maximal pain reduction from the baseline was 62 +/- 7% for lidocaine, 43 +/- 7% for amantadine, and 47 +/- 7% for the placebo. Straight leg raise test also significantly improved with lidocaine (from 30 to 37 degrees; P < .05), as compared to amantadine (34-36 degrees) and to the placebo (32-34 degrees). All three treatments were relatively well tolerated.

Conclusions: Intravenous lidocaine, rather than amantadine, reduces both spontaneous and evoked sciatic pain.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Amantadine / adverse effects
  • Amantadine / therapeutic use*
  • Analgesics, Non-Narcotic / adverse effects
  • Analgesics, Non-Narcotic / therapeutic use*
  • Anesthetics, Local / adverse effects
  • Anesthetics, Local / therapeutic use
  • Double-Blind Method
  • Drug Therapy, Combination
  • Female
  • Humans
  • Injections, Intravenous
  • Lidocaine / adverse effects
  • Lidocaine / therapeutic use*
  • Male
  • Middle Aged
  • Sciatica / drug therapy*


  • Analgesics, Non-Narcotic
  • Anesthetics, Local
  • Lidocaine
  • Amantadine