This case study describes a patient with suspected opioid-induced bowel dysfunction who had improved pain control when treated with intravenous (IV) lidocaine. An 80-year-old man with failed back surgery syndrome managed with an intrathecal (IT) pump presented with protracted abdominal pain. The acute pain service initiated a lidocaine infusion at 1 mg·min−1, and the patient reported significant pain relief. The patient experienced refractory abdominal pain with 3 attempts to wean the lidocaine infusion. Eventually, a successful transitional regimen was achieved with methylnaltrexone and transdermal lidocaine patches. Lidocaine infusions may be an effective and underutilized multimodal adjunct for nonsurgical pain conditions.
From the Department of Anesthesiology, Virginia Commonwealth University Richmond, Virginia.
Accepted for publication June 17, 2019.
The authors declare no conflicts of interest.
Address correspondence to Bryant W. Tran, MD, Department of Anesthesiology, Virginia Commonwealth University Medical Center, 1200 E Broad St, Box 980695, Richmond, VA 23298. Address e-mail to firstname.lastname@example.org.