The Role of Intravenous (IV) Lidocaine in the Management of Chronic Neuropathic Pain of Peripheral Nerve Origin - Full Text View

Purpose

Pain as a result of nerve injury (neuropathic pain) is a particularly severe form of chronic pain. Common examples of neuropathic pain are pain due to diabetes and shingles. There is good evidence that an intravenous infusion of lidocaine (local anesthetic) is useful for the management of neuropathic pain in the short term - up to six hours.

Condition	Intervention
Neuropathic Pain	Drug: Lidocaine Drug: Diphenhydramine


Study Type:	Interventional
Study Design:	Allocation: Randomized Intervention Model: Crossover Assignment Masking: Triple (Participant, Care Provider, Investigator)
Official Title:	The Role of Intravenous (IV) Lidocaine in the Management of Chronic Neuropathic Pain of Peripheral Nerve Origin

Resource links provided by NLM:

Drug Information available for: Promethazine hydrochloride Diphenhydramine Promethazine Lidocaine hydrochloride Lidocaine Diphenhydramine hydrochloride Diphenhydramine citrate

U.S. FDA Resources

Further study details as provided by Dwight Moulin, Lawson Health Research Institute:

Primary Outcome Measures:

Changes from Baseline Pain scores on the Visual Analog Scale at 6 weeks [ Time Frame: every 24 hours for six weeks post-infusion ]

Secondary Outcome Measures:

Hospital Anxiety and Depression Scale [ Time Frame: obtained baseline, 24 and 72 hours and then weeks 1,2,3, and 4 ]
Modified Brief Pain Inventory [ Time Frame: obtained baseline, 24, 72 hours and then weeks 1,2,3 and 4 ]
Leeds Sleep Evaluation Questionnaire [ Time Frame: obtained baseline, 24, 72 hours and then weeks 1,2,3 and 4 ]
Patient Global Satisfaction with Treatment and Impression of Change [ Time Frame: obtained baseline, 24, 72 hours and then weeks 1,2,3 and 4 ]
Side Effects [ Time Frame: obtained baseline, 24, 72 hours and then weeks 1,2,3 and 4 ]
Quality of Life Health Outcome Instrument [ Time Frame: obtained baseline, 24, 72 hours and then weeks 1,2,3 and 4 ]


Enrollment:	34
Study Start Date:	September 2011
Study Completion Date:	December 2015
Primary Completion Date:	December 2015 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Placebo Comparator: Diphenhydramine(Benadryl)	Drug: Diphenhydramine Diphenhydramine 50 mg in 250 ml of normal saline infused over 45 minutes. Other Name: Benadryl
Active Comparator: Lidocaine	Drug: Lidocaine Lidocaine 5 mg/kg in 250 ml of normal saline infused over 45 minutes. Other Name: Xylocaine

Detailed Description:

This study will examine the role of intravenous lidocaine in the relief of neuropathic pain over four weeks following infusion compared to a salt water infusion. If we can show that intravenous lidocaine provides sustained benefit for up to one month, this will be a major advance in the management of individuals suffering from neuropathic pain.

Eligibility


Ages Eligible for Study:	18 Years to 80 Years (Adult, Senior)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Chronic neuropathic pain due to diabetes mellitus or herpes zoster and a score of 4/10 or greater on the DN4 questionnaire.
Moderate to severe pain as defined by screening average pain intensity of 5 or greater on a 0-10 numerical rating scale.
Neuropathic pain duration of at least 6 months.

Exclusion Criteria:

Presence of clinically significant cardiac disease.
Poorly controlled seizure disorder.
Significant psychiatric disorder.
History of allergy to lidocaine or any other amide local anesthetic
History of allergy to diphenhydramine.
Prior treatment with a local anesthetic infusion.
Neuropathic pain due to cancer or complex regional pain syndrome
Language barrier or cognitive impairment that would preclude understanding of the study and filling out of questionnaires
Lack of a driver to transport the patient to and from the pain clinic.

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01669967

Locations


Canada, Ontario
St. Joseph's Health Care
London, Ontario, Canada, N6A 4V2

Sponsors and Collaborators

Lawson Health Research Institute

Investigators


Principal Investigator:	Dwight Moulin, Dr.	University of Western Ontario, Canada

More Information


Responsible Party:	Dwight Moulin, Dr. D. Moulin Professor, Departments of Clinical Neurological Sciences and Oncology, Lawson Health Research Institute
ClinicalTrials.gov Identifier:	NCT01669967 History of Changes
Other Study ID Numbers:	R11-132 17806 ( Other Identifier: University of Western Ontario )
Study First Received:	June 22, 2012
Last Updated:	March 19, 2016

Additional relevant MeSH terms:


Neuralgia Pain Neurologic Manifestations Nervous System Diseases Peripheral Nervous System Diseases Neuromuscular Diseases Signs and Symptoms Lidocaine Diphenhydramine Promethazine Anesthetics, Local Anesthetics Central Nervous System Depressants Physiological Effects of Drugs Sensory System Agents	Peripheral Nervous System Agents Anti-Arrhythmia Agents Voltage-Gated Sodium Channel Blockers Sodium Channel Blockers Membrane Transport Modulators Molecular Mechanisms of Pharmacological Action Antiemetics Autonomic Agents Gastrointestinal Agents Histamine H1 Antagonists Histamine Antagonists Histamine Agents Neurotransmitter Agents Hypnotics and Sedatives Anti-Allergic Agents

ClinicalTrials.gov processed this record on September 21, 2017