Comparison of intravenous lidocaine versus morphine in alleviating pain in patients with critical limb ischaemia

Emerg Med J. 2015 Jul;32(7):516-9. doi: 10.1136/emermed-2014-203944. Epub 2014 Aug 21.


Background: Numerous drugs have been proposed to alleviate ischaemic limb pain, but none have been successful in relieving ischaemic pain thoroughly and rapidly.

Objective: To compare the effectiveness of intravenous lidocaine and intravenous morphine in decreasing pain in patients with critical limb ischaemia.

Methods: A randomised double-blind controlled trial was performed in 63 patients with critical limb ischaemia recruited from the emergency department between October 2012 and December 2013; 23 patients were excluded and the remainder were randomly divided into two groups of 20 patients. Patients in the lidocaine group received lidocaine infusion (2 mg/kg) while patients in the morphine group received morphine (0.1 mg/kg). Patients' visual analogue pain scores (VAS), from 0 to 10, were reported before and 15 and 30 min after the infusion.

Results: Before the infusion the mean±SD VAS score was 7.50±1.93 in the lidocaine group and 7.65±1.92 in the morphine group. At 15 min the mean±SD VAS score in the lidocaine group was lower than in the morphine group (5.75±1.77 vs 7.00±1.83; mean difference 1.25, 95% CI 0.095 to 2.405) and, at 30 min, the mean±SD VAS score in the lidocaine group was again lower (4.25±1.48 vs 6.50±1.73; mean difference 2.25, 95% CI 1.218 to 3.282).

Conclusions: Lidocaine may be helpful in decreasing ischaemic pain in patients with critical limb ischaemia.

Trial registration number: http://www.irct.irIRCT201210148872N2.

Keywords: analgesia/pain control.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Intravenous
  • Adult
  • Aged
  • Analgesics, Opioid / administration & dosage*
  • Critical Illness
  • Double-Blind Method
  • Emergency Service, Hospital / statistics & numerical data
  • Extremities / blood supply*
  • Female
  • Humans
  • Ischemia / complications*
  • Lidocaine / administration & dosage*
  • Male
  • Middle Aged
  • Morphine / administration & dosage*
  • Pain / drug therapy*
  • Pain / etiology
  • Pain Measurement


  • Analgesics, Opioid
  • Morphine
  • Lidocaine

Associated data

  • IRCT/201210148872N2