van den Heuvel Sandra A S, van der Wal Selina E I, Smedes Lotte A, Radema Sandra A, van Alfen Nens, Vissers Kris C P, Steegers Monique A H
Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Center (RUNMC), Nijmegen, Netherlands.
Department of Medical Oncology, RUNMC, Nijmegen, Netherlands.
Pain Res Manag. 2017;2017:8053474. doi: 10.1155/2017/8053474. Epub 2017 Mar 28.
Treatment of intractable pain due to chemotherapy induced peripheral neuropathy (CIPN) is a challenge. Intravenous (iv) lidocaine has shown to be a treatment option for neuropathic pain of different etiologies. Lidocaine (1.5 mg/kg in 10 minutes followed by 1.5 mg/kg/h over 5 hours) was administered in nine patients with CIPN, and analgesic effect was evaluated during infusion and after discharge. The immediate effect of lidocaine on pressure pain thresholds (PPT) and the extent of the stocking and glove distribution of sensory abnormalities (cold and pinprick) were assessed. Lidocaine had a significant direct analgesic effect in 8 out of 9 patients ( = 0.01) with a pain intensity difference of >30%. Pain reduction persisted in 5 patients for an average of 23 days. Lidocaine did not influence mean PPT, but there was a tendency that the extent of sensory abnormalities decreased after lidocaine. Iv lidocaine has direct analgesic effect in CIPN with a moderate long-term effect and seems to influence the area of cold and pinprick perception. Additional research is needed, using a control group and larger sample sizes to confirm these results.
化疗引起的周围神经病变（CIPN）所致顽固性疼痛的治疗颇具挑战。静脉注射利多卡因已被证明是治疗不同病因所致神经病理性疼痛的一种选择。对9例CIPN患者静脉注射利多卡因（10分钟内注射1.5mg/kg，随后5小时内以1.5mg/kg/小时的速度注射），并在输液期间和出院后评估镇痛效果。评估了利多卡因对压力疼痛阈值（PPT）的即时影响以及感觉异常（冷觉和针刺觉）的袜套样和手套样分布范围。9例患者中有8例（P = 0.01）利多卡因具有显著的直接镇痛作用，疼痛强度差异>30%。5例患者的疼痛减轻持续平均23天。利多卡因对平均PPT无影响，但利多卡因注射后感觉异常范围有减小的趋势。静脉注射利多卡因对CIPN有直接镇痛作用，具有中度长期效果，似乎会影响冷觉和针刺觉的区域。需要使用对照组和更大样本量进行进一步研究以证实这些结果。
