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Intravenous Lidocaine for Chronic Pain: A Review of the Clinical Effectiveness and Guidelines

Last updated: January 26, 2018
Project Number: RC0957-000
Product Line: Rapid Response
Research Type: Drug
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of intravenous lidocaine for chronic pain?
  2. What are the evidence-based guidelines on the use of intravenous lidocaine for chronic pain?

Key Message

Evidence from two systematic reviews was limited in quality and quantity and addressed a wide range of causes of chronic pain. The findings were inconsistent and limited the ability to draw firm conclusions about the effectiveness of intravenous lidocaine for chronic pain.Relevant evidence from one of two identified guideline documents was more useful. Although both guideline documents were published in 2012, one set of guidelines provided a Grade B recommendation on the use of intravenous lidocaine for neuropathic pain but with evidence lacking in certain areas. The other guideline considered one study of intravenous lidocaine and did not support the use of intravenous lidocaine in the recommendation for the management of fibromyalgia.