Gupta Harshit, Patel Anjana, Eswani Zahaan, Moore Peyton, Steib Mattie, Lee Christopher, Kaye Alan D
University of California Los Angeles.
Georgetown University.
Orthop Rev (Pavia). 2021 Jul 11;13(2):25567. doi: 10.52965/001c.25567. eCollection 2021.
This is a comprehensive review of the literature regarding intravenous lidocaine infusion to treat peripheral neuropathy. The clinical symptoms of peripheral neuropathy occur on a broad spectrum and stem from many etiologies resulting in complex treatment approaches. This review presents the background, evidence, and indications for the use of intravenous lidocaine infusions as a treatment option for this condition.
The clinical range of peripheral neuropathy symptoms includes pain, numbness, muscle weakness, paresthesia, balance difficulty, and autonomic dysfunction. However, severe neuropathic pain remains one of the most debilitating symptoms that significantly affects the quality of life. Current treatment options include antidepressants, anticonvulsants, and, in some cases, opiates, but these are often ineffective, creating the need for other therapeutic approaches.The pathophysiology of neuropathic pain involves sodium channels which create abnormal pain responses. Intravenous lidocaine primarily functions by inhibiting membrane sodium channels which desensitize peripheral nociceptors, thus creating an analgesic effect. The research in using intravenous lidocaine for neuropathic pain is not fully complete and requires further evaluation.
Peripheral neuropathy is a manifestation commonly resulting from diabetes, alcohol abuse, vitamin deficiencies, and chemotherapy, among other causes. One of the most significant complications is neuropathic pain which is often resistant to multi-modal therapeutic regimens. Intravenous lidocaine infusions are a newer treatment option for neuropathic pain, which have additional anti-inflammatory effects with a minimal side effect profile. Studies have concluded it effectively treats neuropathic pain for weeks after administration, but results are variable depending on specific procedures. Further research, including additional direct comparison studies, should be conducted to fully evaluate this drug's usefulness.
这是一篇关于静脉输注利多卡因治疗周围神经病变的文献综述。周围神经病变的临床症状范围广泛，病因众多，导致治疗方法复杂。本综述介绍了静脉输注利多卡因作为这种疾病治疗选择的背景、证据和适应证。
周围神经病变症状的临床范围包括疼痛、麻木、肌肉无力、感觉异常、平衡困难和自主神经功能障碍。然而，严重的神经病理性疼痛仍然是最使人衰弱的症状之一，严重影响生活质量。目前的治疗选择包括抗抑郁药、抗惊厥药，在某些情况下还包括阿片类药物，但这些药物往往无效，因此需要其他治疗方法。神经病理性疼痛的病理生理学涉及钠通道，这些通道会产生异常的疼痛反应。静脉输注利多卡因主要通过抑制膜钠通道发挥作用，使外周伤害感受器脱敏，从而产生镇痛效果。关于静脉输注利多卡因治疗神经病理性疼痛的研究尚未完全完成，需要进一步评估。
周围神经病变是糖尿病、酗酒、维生素缺乏和化疗等多种原因常见的表现。最严重的并发症之一是神经病理性疼痛，它通常对多模式治疗方案有抵抗性。静脉输注利多卡因是治疗神经病理性疼痛的一种较新的选择，具有额外的抗炎作用，副作用最小。研究得出结论，给药后数周内它能有效治疗神经病理性疼痛，但结果因具体程序而异。应进行进一步研究，包括更多的直接比较研究，以全面评估这种药物的效用。
