Kandil Enas, Melikman Emily, Adinoff Bryon
Department of Anesthesiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
J Anesth Clin Res. 2017 Jan;8(1). doi: 10.4172/2155-6148.1000697. Epub 2017 Jan 11.
Opioid abuse is a national epidemic in the United States, where it is estimated that a prescription drug overdose death occurs every 19 minutes. While opioids are highly effective in acute and subacute pain control, their use for treatment of chronic pain is controversial. Chronic opioids use is associated with tolerance, dependency, hyperalgesia. Although there are new strategies and practice guidelines to reduce opioid dependence and opioid prescription drug overdose, there has been little focus on development of opioid-sparing therapeutic approaches. Lidocaine infusion has been shown to be successful in controlling pain where other agents have failed. The opioid sparing properties of lidocaine infusion added to its analgesic and antihyperalgesic properties make lidocaine infusion a viable option for pain control in opioid dependent patients. In this review, we provide an overview of the opioid abuse epidemic, and we outline current evidence supporting the potential use of lidocaine infusion as an adjuvant therapeutic approach for management of chronic pain.
阿片类药物滥用在美国是一场全国性的流行病,据估计每19分钟就有1例处方药过量致死事件发生。虽然阿片类药物在急性和亚急性疼痛控制方面非常有效,但其用于慢性疼痛治疗存在争议。长期使用阿片类药物会导致耐受性、依赖性和痛觉过敏。尽管有新的策略和实践指南来减少阿片类药物依赖和阿片类处方药过量,但对于开发减少阿片类药物使用的治疗方法关注甚少。在其他药物治疗失败的情况下,输注利多卡因已被证明能成功控制疼痛。利多卡因输注的减少阿片类药物使用特性及其镇痛和抗痛觉过敏特性,使其成为阿片类药物依赖患者疼痛控制的可行选择。在本综述中,我们概述了阿片类药物滥用的流行情况,并概述了支持将利多卡因输注作为慢性疼痛管理辅助治疗方法的现有证据。