Yang Kevin J, Mistry Porus D
Keck School of Medicine, University of Southern California (USC), Los Angeles, United States of America.
Department of Anesthesiology, Keck Medicine of the University of Southern California (USC), Los Angeles, United States of America.
Open Med (Wars). 2024 Dec 3;19(1):20241102. doi: 10.1515/med-2024-1102. eCollection 2024.
Complex regional pain syndrome (CRPS) is a chronic pain condition most often triggered by direct injury to an extremity that is characterized by disproportionate pain, sensory abnormalities, and autonomic dysfunction. Early research into intravenous lidocaine therapy for CRPS has demonstrated promise, but clinical evidence remains scarce. We report on 12 patients with chronic CRPS who underwent intravenous lidocaine therapy and discuss our findings in the context of the existing literature.
Patients ages ranged from 25 to 64 years. Duration of CRPS ranged from 4 to 25 years. The majority of patients (8/12, 67%) reported adequate subjective pain relief with intravenous lidocaine therapy, whereas four patients reported inadequate subjective pain relief with therapy. All patients were being treated with at least one other pharmacotherapy. Three patients experienced minor side effects.
Our cases, taken with existing evidence, suggest that intravenous lidocaine for the treatment of chronic CRPS is safe and may decrease the pain associated with chronic CRPS. However, this study lacks adequate sample size to make those conclusions confidently. We recommend a randomized placebo-controlled multicenter clinical trial to establish the efficacy and side effect profile of systemic intravenous lidocaine more confidently for the treatment of pain due to chronic CRPS.
复杂性区域疼痛综合征（CRPS）是一种慢性疼痛病症，最常由肢体直接损伤引发，其特征为疼痛程度不成比例、感觉异常和自主神经功能障碍。早期关于静脉注射利多卡因治疗CRPS的研究已显示出前景，但临床证据仍然匮乏。我们报告了12例接受静脉注射利多卡因治疗的慢性CRPS患者，并结合现有文献讨论我们的研究结果。
患者年龄在25岁至64岁之间。CRPS病程为4年至25年。大多数患者（8/12，67%）报告静脉注射利多卡因治疗后主观疼痛得到充分缓解，而4例患者报告治疗后主观疼痛缓解不足。所有患者均至少接受一种其他药物治疗。3例患者出现轻微副作用。
我们的病例结合现有证据表明，静脉注射利多卡因治疗慢性CRPS是安全的，可能会减轻与慢性CRPS相关的疼痛。然而，本研究样本量不足，无法自信地得出这些结论。我们建议开展一项随机安慰剂对照多中心临床试验，以便更自信地确定全身静脉注射利多卡因治疗慢性CRPS所致疼痛的疗效和副作用情况。
