Stavropoulou Evmorfia, Argyra Erifili, Zis Panagiotis, Vadalouca Athina, Siafaka Ioanna
1st Anaesthesiology Clinic, Pain Relief and Palliative Care Unit, Aretaieion University Hospital, 76 Vas. Sofias Avenue, 11527 Athens, Greece.
Department of Neurology, Evangelismos General Hospital, 45-47 Ipsilantou Street, 10676 Athens, Greece.
ISRN Pain. 2014 Mar 10;2014:853826. doi: 10.1155/2014/853826. eCollection 2014.
Trigeminal neuralgia is the most common neuralgia. Its therapeutic approach is challenging as the first line treatment often does not help, or even causes intolerable side effects. The aim of our randomized double blind, placebo controlled, crossover study was to investigate in a prospective way the effect of lidocaine in patients with trigeminal neuralgia. Twenty patients met our inclusion criteria and completed the study. Each patient underwent four weekly sessions, two of which were with lidocaine (5 mgs/kg) and two with placebo infusions administered over 60 minutes. Intravenous lidocaine was superior regarding the reduction of the intensity of pain, the allodynia, and the hyperalgesia compared to placebo. Moreover, contrary to placebo, lidocaine managed to maintain its therapeutic results for the first 24 hours after intravenous infusion. Although, intravenous lidocaine is not a first line treatment, when first line medications fail to help, pain specialists may try it as an add-on treatment. This trial is registered with NCT01955967.
三叉神经痛是最常见的神经痛。其治疗方法具有挑战性，因为一线治疗往往无效，甚至会导致无法忍受的副作用。我们这项随机双盲、安慰剂对照、交叉研究的目的是前瞻性地研究利多卡因对三叉神经痛患者的疗效。20名患者符合我们的纳入标准并完成了研究。每位患者每周接受4次治疗，其中2次使用利多卡因（5毫克/千克），另外2次使用安慰剂，输液时间为60分钟。与安慰剂相比，静脉注射利多卡因在减轻疼痛强度、治疗异常性疼痛和痛觉过敏方面更具优势。此外，与安慰剂不同的是，利多卡因在静脉输注后的头24小时内能够维持其治疗效果。虽然静脉注射利多卡因并非一线治疗方法，但当一线药物治疗无效时，疼痛专科医生可以尝试将其作为附加治疗方法。该试验已在ClinicalTrials.gov注册，注册号为NCT01955967。
