What is lignocaine?
Lignocaine, also known as lidocaine, is a local anesthetic (numbing) drug that has been used in anaesthesia, surgery, cardiology and pain medicine for a number of years.
What conditions can lignocaine infusions help with?
In chronic pain lignocaine infusion therapy can be used in the treatment of numerous conditions typically associated with neuropathic (nerve) pain. Some of these conditions include:
- Migraines
- Fibromyalgia/complex widespread pain disorders
- Complex regional pain syndrome (CRPS)
- Phantom limb pain
- Pain associated with spinal cord injuries
- Diabetic neuropathy
- Cancer related pain
- Peri-operative pain
- Pain associated with sensitisation
How does lignocaine work?
Lignocaine exerts its effect via a myriad of pathways. In chronic pain it helps to stabilise pain nerves and make them less responsive to excitation. It does this by blocking a chemical called sodium from initiating and transmitting nerve impulses. Lignocaine also has anti-inflammatory effects that are more potent than traditional anti-inflammatory drugs but with fewer side effects.
How effective is a lignocaine infusion?
The effectiveness of a lignocaine infusion does depend on the condition being treated and individual differences. The expected outcome varies from patient to patient and it is difficult to predict your outcome before the infusion. Some patients see an improvement in their pain during the infusion, but in many patients several infusions are required to see any benefit.
A reduction in pain intensity is just one measure of success. Other areas to suggest a positive response include improvement in function, psychological and emotional wellbeing, improvement to sleep and quality of life, and reduction in opioid analgesia.
In chronic pain, benefits can last anywhere from several weeks to months. Your doctor will determine on a case by case basis whether continued treatment with lignocaine is warranted.
How is a lignocaine infusion completed?
Lignocaine infusions can be done as a series of treatments as an outpatient or as a continuous infusion over several days as an inpatient in hospital. Your doctor will have discussed this with you beforehand.
As an inpatient you will be admitted for a period of 6 days and you will be connected to the infusion continuously for 5 days. During the initial 2-3 days your doctor will aim to get you to the “optimal” dose before leaving the infusion on for the next 2-3 days. Once the treatment is completed you will have a short period of observation before being discharged home.
Lignocaine can be given via a number of different ways. You will likely be receiving it as either an IV (intra-venous, in the vein) or SC (subcutaneous, under the skin) infusion. If you are an inpatient the needle will be changed and repositioned every 24 hours to avoid infection and the infusion line will be changed every 72 hours.
During your treatment you will have regular observations taken from the nursing staff including monitoring of your heart rate, blood pressure, respiratory rate, temperature, oxygen saturation and pain scores. Lignocaine can cause changes to these parameters and they will return to normal after you have completed the treatment.
Are there any side effects?
Like all drugs lignocaine is not without its potential side effects. Everyone has a different tolerance to lignocaine and can vary according to the condition being treated. You may not see any side effects, only one or more. These can be managed by reducing the dose/rate or stopping the infusion temporarily.
In general, lignocaine is a well-tolerated treatment at the dosages you will be using. Any side effects that do occur will usually stop once the lignocaine infusion has been ceased. Further dose increases will then be made according to how you are feeling.
Some uncommon potential side effects are:
- Metallic taste
- Dizziness and/or light headedness
- Numbing and/or tingling in and around your mouth
- Blurry vision
- Tinnitus
- Tremor
- Allergic reactions are rare
Other potential complications can occur as part of being in hospital. These can include:
- Blood clots: can be effectively prevented by keeping active such as walking around ward
- Infection at site of needle: nurses will regularly change needle site to prevent this
Can anyone have a lignocaine infusion?
If you are pregnant, have any serious cardiac conditions or have had a previous allergic reaction to lignocaine then a lignocaine infusion may not be suitable for you. Your doctor will have assessed this before your treatment.
Will I need any other medications as part of a lignocaine infusion?
You will not require any additional medications outside of what you are currently using.
Is there any specific preparation before the lignocaine infusion?
In most cases you will not need any specific preparation before the lignocaine infusion. In some instances, you may be required to complete an ECG and blood tests (Mg levels, liver and kidney function). You will be informed by your doctor if this is required.
What happens after the infusion?
Once the infusion is complete you will have the treatment disconnected and the treatment needle removed. You will need to stay in hospital for a couple of hours for post treatment observations. Once everything is cleared by the hospital staff you will be discharged home. You will have a follow up appointment with your treating Anodyne doctor usually within a few weeks of discharge.
While most people are able to return to normal activity once discharged, we recommend that you do not sign any legally binding documents, drive a motor vehicle or operate machinery for 24 hours after stopping the lignocaine infusion.
Is a lignocaine infusion right for you?
If you think a lignocaine infusion may be right for you talk to your doctor about it. If you would like any further information or would like to see one of our doctors please do not hesitate to contact Anodyne.