Tertiary Care Clinical Experience with Intravenous Lidocaine Infusions for the Treatment of Chronic Pain

Pain Med. 2018 Jun 1;19(6):1245-1253. doi: 10.1093/pm/pnx167.


Objective: To evaluate the safety of and long-term pain relief due to intravenous lidocaine infusion for the treatment of chronic pain in a tertiary pain management clinic.

Design: Retrospective chart review.

Methods: Medical records were reviewed from 233 adult chronic pain patients who underwent one to three lidocaine infusions. The initial lidocaine challenge consisted of 1,000 mg/h administered intravenously for up to 30 minutes until infusion was complete, full pain resolution, the patient requested to stop, side effects (SEs) became intolerable, and/or if there were any safety concerns. Subsequent infusions were tailored to patient response. Data reviewed included pain diagnosis, lidocaine dose, SEs, and duration of pain relief documented at a follow-up visit.

Results: Patients primarily had neuropathic pain (80%), were 94% white, 58% were female, and there was an average pain duration of 7.9 years. SEs were usually mild and transient, including perioral tingling, dizziness, tinnitus, and nausea/vomiting, and they were uncommon after the initial infusion. Overall, 41% of patients showed long-lasting pain relief, with positive response to the initial infusion associated with receiving and benefitting from subsequent infusions. Benefit by pain diagnoses varied from 32% to 58%.

Conclusions: Our retrospective study in a heterogeneous population with chronic pain suggests that intravenous lidocaine is a safe treatment. Data also suggest long-term pain relief in a significant proportion of patients. Additional study is important in order to delineate patient selection, determine optimal dosing and treatment frequency, assess pain reduction and duration, and treatment cost-effectiveness.

MeSH terms

  • Adult
  • Aged
  • Anesthetics, Local / administration & dosage*
  • Chronic Pain / drug therapy*
  • Female
  • Humans
  • Infusions, Intravenous
  • Lidocaine / administration & dosage*
  • Male
  • Middle Aged
  • Pain Management / methods*
  • Retrospective Studies
  • Tertiary Healthcare
  • Treatment Outcome


  • Anesthetics, Local
  • Lidocaine