Tully Janell, Jung Jai Won, Patel Anjana, Tukan Alyson, Kandula Sameer, Doan Allen, Imani Farnad, Varrassi Giustino, Cornett Elyse M, Kaye Alan David, Viswanath Omar, Urits Ivan
College of Medicine-Phoenix, University of Arizona, Phoenix, AZ, USA.
School of Medicine, Georgetown University, Washington, DC, USA.
Anesth Pain Med. 2021 Jan 2;10(6):e112290. doi: 10.5812/aapm.112290. eCollection 2020 Dec.
Chronic pain accounts for one of the most common reasons patients seek medical care. The financial burden of chronic pain on health care is seen by direct financial cost and resource utilization. Many risk factors may contribute to chronic pain, but there is no definite risk. Managing chronic pain is a balance between maximally alleviating symptoms by utilizing a therapeutic regimen that is safe for long-term use. Currently, non-opioid analgesics, NSAIDs, and opioids are some of the medical treatment options, but these have numerous adverse effects and may not be the best option for long-term use. However, Lidocaine can achieve both central and peripheral analgesic effects with relatively few side effects, which may be an ideal compound for managing chronic pain.
This is a Narrative Review.
Infusion of lidocaine (2-(diethylamino)-N-(2,6-dimethylphenyl)acetamide), an amino-amide compound, is emerging as a promising option to fill the therapeutic void for treatment of chronic pain. Numerous studies have outlined dosing protocols for lidocaine infusion for the management of perioperative pain, outlined below. While there are slight variations in these different protocols, they all center around a similar dosing regimen to administer a bolus to reach a rapid steady state, followed by infusion for up to 72 hours to maintain the therapeutic analgesic effects.
Lidocaine may be a promising pharmacologic solution with a low side effect profile that provides central and peripheral analgesia. Even though the multifaceted mechanism is not entirely understood yet, lidocaine may be a promising novel remedy in treating chronic pain in various conditions.
慢性疼痛是患者寻求医疗护理的最常见原因之一。慢性疼痛对医疗保健的经济负担体现在直接的经济成本和资源利用上。许多风险因素可能导致慢性疼痛，但尚无明确的风险因素。管理慢性疼痛需要在通过采用对长期使用安全的治疗方案最大程度缓解症状之间取得平衡。目前，非阿片类镇痛药、非甾体抗炎药和阿片类药物是一些医疗治疗选择，但这些药物有许多不良反应，可能不是长期使用的最佳选择。然而，利多卡因可以在副作用相对较少的情况下实现中枢和外周镇痛效果，这可能是管理慢性疼痛的理想化合物。
这是一篇叙述性综述。
输注利多卡因（2-（二乙氨基）-N-（2,6-二甲基苯基）乙酰胺），一种氨基酰胺化合物，正成为填补慢性疼痛治疗治疗空白的有前景的选择。许多研究已经概述了用于围手术期疼痛管理的利多卡因输注给药方案，如下所述。虽然这些不同方案略有差异，但它们都围绕类似的给药方案，即先给予负荷剂量以迅速达到稳态，然后输注长达72小时以维持治疗性镇痛效果。
利多卡因可能是一种有前景的药理学解决方案，副作用小，可提供中枢和外周镇痛。尽管其多方面的机制尚未完全了解，但利多卡因可能是治疗各种情况下慢性疼痛的有前景的新疗法。
