Lidocaine infusion has been shown to be successful in controlling pain where other agents have failed. It has a wonderful double effect-- it reduces the need for opioids and it diminishes a side effect in which opioids actually make pain worse! This makes lidocaine infusion a viable option for pain control in opioid dependent patients.
Its been used since the 1940's for chronic pain.
Its mechanism of action is thought to involve "rewiring" pain pathways so that allodynia (feeling pain without a painful stimulus) and hyperalgesia (increased sensitivity to pain) are reduced. It also has a potent anti-inflammatory effect. While topical creams provide some local relief at the site of an injury, they do not "rewire" the circuitry of pain like an intravenous infusion.
Lidocaine infusion treatment is provided in a safe, nurturing and healing environment. Patients are treated in private, comfortable treatment rooms with space to accommodate a family member or friend during the infusion. All infusions are supervised by a physician.
Many find it helpful and relaxing to listen to music and to wear an eyeshade or sunglasses. It can be difficult to carry on a conversation during the procedure, so you are encouraged to sit back and relax and pay attention to what you are feeling. Expectations coming in to the treatment do affect the experience, so it is helpful to decide ahead of time that you will be safe, will feel “weird” for a little while, and that is ok, because that will quickly pass and you will be left feeling much better.
Patients meeting screening criteria will be scheduled for their first infusion appointment and consultation. During your appointment, you will discuss your treatment history, medical conditions and plan for the infusion. Your weight and vital signs will be recorded and used to determine dose of medication. A physician or nurse will place your IV and the infusion will begin.
Lidocaine may not put you to sleep. If you are already sleepy and are feeling very calm and relaxed during the treatment, you might drift off for a short nap.
The medicine is given very slowly over 60 minutes. The first 5 minutes are uneventful with no noticeable effects. Soon after the infusion, people tend to notice some blurring of vision or double vision, a feeling of “lightness”, numbness around the mouth or a metallic taste sensation. Over the course of the first 30 minute period, these feelings tend to build, so that the medicine is at the peak of its intensity at the very end. Less commonly, people may experience some anxiety and headache, nausea, or sweating . These feelings start to subside approximately 10-15 minutes after the medicine is done and last for a total of 60 minutes. Most people can expect to be with us for about 90 to 120 minutes from the time you walk in the door to when you leave, with no side effects at that point and none between treatments. You will be provided with post procedure instructions and will receive a call the day following your first infusion to see how you are feeling.
Typically, it will take just 1 or 2 infusions to know if Lidocaine will help you. If you are having positive results, it is recommended to have 2 total infusions within the first month. After that, maintenance (booster) infusions may be scheduled to maintain response. The total length of treatment is highly dependent on each individual’s unique circumstances.
Lidocaine infusion therapy is not a covered by insurance.