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The Analgesic and Emotional Response to Intravenous Lidocaine Infusion in the Treatment of Postherpetic Neuralgia

A Randomized, Double-Blinded, Placebo-controlled Study

Liu, Hui, MD, PhD*; Lu, Fan, MD; Zhou, Dan, MD*; Yin, Yan, MD, PhD*; Li, Jun, MD, PhD*; Yang, BangXiang, MD, PhD*; Song, Li, MD, PhD*; Ye, Ling, MD, PhD*; Xiao, Hong, MD, PhD*

doi: 10.1097/AJP.0000000000000623
Original Articles

Objectives: This study evaluated the analgesic efficacy and emotional response to intravenous lidocaine infusion compared with placebo in patients with postherpetic neuralgia (PHN).

Methods: In this randomized, double-blinded study, patients with PHN received 5 mg/kg intravenous lidocaine infusion or placebo. The primary outcome was pain measured by Visual Analogue Scale, Von Frey, and area of allodynia. Moreover, emotional status of anxiety and depression were evaluated by Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS). Quality of life was assessed by Short Form Health Survey 36.

Results: In total, 197 patients were enrolled and eligible data were collected from 183 of those patients. The Visual Analogue Scale scores were reduced to a minimum at 2 weeks (2.74, 2.99) after infusion, but no significant difference was found between the lidocaine and placebo groups. Similar changes were also found in mechanical pain threshold and area of allodynia. However, the lidocaine group was associated with a statistically significant reduction in consumption of analgesics with a relative risk of 6.2 (95% confidence interval [CI], 2.24-17.16). Lidocaine infusion also significantly improved the anxiety and depression status; the values of mean change in anxiety and depression were 3.89 (95% CI, 1.43-6.35) and 4.3 (95% CI, 0.63-7.98), respectively, at 2 weeks. Moreover, improvement was exhibited in Short Form Health Survey 36 health status, with the mean change of 49.81 (95% CI, 28.17-71.46) at 1 week, in particular scores on vitality, physical and emotional role functioning, and mental health.

Conclusions: The analgesic response of 5 mg/kg lidocaine intravenous infusion is comparable to placebo in patients with PHN, but intravenous lidocaine infusion significantly reduced total analgesic consumption, and improved the overall emotional and health status.

*Department of Pain Management, West China Hospital, Sichuan University

Department of Anesthesiology, Sichuan Cancer Center, Sichuan Cancer Hospital & Institute, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China

H.L., F.L., and D.Z. contributed equally and should be regarded as co-first authors.

Supported by grant No. 30872435 from the National Research Foundation of Nature Science, Beijing, China, and the grant of National key clinical specialty construction project of the Ministry of Health, Beijing, China. The authors declare no conflict of interest.

Reprints: Hong Xiao, MD, PhD, Department of Pain Management, West China Hospital, Sichuan University, Chengdu 610000, China (e-mail:

Received December 29, 2017

Received in revised form April 5, 2018

Accepted April 14, 2018

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.