Efficacy and adverse effects of intravenous lignocaine therapy in fibromyalgia syndrome

BMC Musculoskeletal Disorders

GD Kitas²  GJ Treharne³  JL Southall¹  JH Raphael¹ 

[1] Department of Pain Management, Dudley Group of Hospitals NHS Trust, West Midlands, UK;Department of Rheumatology, Dudley Group of Hospitals NHS Trust, West Midlands, UK;School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK

关键词: Quality of Life;    Depression;    Psychosocial;    Pain;    Benefits;    Side-Effects;    Adverse Effects;    Intravenous;    Lidocaine;    Fibromyalgia;   

Others  :  1166286
DOI  :  10.1186/1471-2474-3-21

 received in 2002-06-12, accepted in 2002-09-08,  发布年份 2002

【 摘 要 】

Background

To investigate the effects of intravenous lignocaine infusions (IV lignocaine) in fibromyalgia.

Methods

Prospective study of the adverse effects of IV lignocaine in 106 patients with fibromyalgia; retrospective questionnaire study of the efficacy of IV lignocaine in 50 patients with fibromyalgia.

Results

Prospective study: Two major (pulmonary oedema and supraventricular tachycardia) and 42 minor side-effects were reported. None had long-term sequelae. The commonest was hypotension (17 cases). Retrospective study: Pain and a range of psychosocial measures (on single 11-point scales) improved significantly after treatment. There was no effect of the treatment on work status. The average duration of pain relief after the 6-day course of treatment was 11.5 ± 6.5 weeks.

Conclusions

Intravenous lignocaine appears to be both safe and of benefit in improving pain and quality of life for patients with fibromyalgia. This needs to be confirmed in prospective randomised controlled trials.

【 授权许可】

   
2002 Raphael et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.

【 图 表 】

Figure 1.

Figure 2.

【 参考文献 】

• [1]Wolfe F, Smythe HA, Yunus MB, et al.: The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: Report of the Multicenter Criteria Committee. Arthritis Rheum 1990, 33:160-72.
• [2]Wolfe F, Ross K, Anderson J, Russell IJ, Hebert L: The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheum 1995, 38:19-27.
• [3]Bennett RM: Fibromyalgia and the disability dilemma: A new era in understanding a complex, multidimensional pain syndrome. Arthritis Rheum 1996, 39:1627-34.
• [4]Ledingham J, Doherty S, Doherty M: Primary fibromyalgia syndrome: An outcome study. Br J Rheumatol 1993, 32:139-42.
• [5]Goldenberg DC, Felson DT, Dinerman H: A randomized controlled trial of amitriptyline and naproxen in the treatment of patients with fibromyalgia. Arthritis Rheum 1986, 29:1371-7.
• [6]Clark S, Tindall E, Bennett RM: A double blind crossover trial of prednisolone versus placebo in the treatment of fibrositis. J Rhematol 1985, 12:980-3.
• [7]Crofford LJ: Meta-analysis of antidepressants in fibromyalgia. Curr Rheumatol Rep 2001, 3(2):115.
• [8]Jaeschke R, Adachi JD, Guyatt G, Keller J, Wong B: Clinical usefulness of amitriptyline in fibromyalgia: the results of 23 N-of-1 randomized controlled trials. J Rheumatol 1991, 18:447-51.
• [9]Burckhardt , Clark SR, Campbell SM, O'Reilly GA, Weins AN, Bennett RM: Multidisciplinary treatment of fibromyalgia. Scan J Rheumatol 1992, 21(Suppl):51.
• [10]Deluze C, Bosia L, Zirbs A, Chantraine A, Vischer T: Electroacupuncture in fibromyalgia: results of a controlled trial. Br Med J 1992, 305:1249-52.
• [11]McCain GA, Bell DA, Mai FM, Halliday PD: A controlled study of the effects of a supervised cardiovascular fitness training program on the manifestations of fibromyalgia. Arthrits Rheum 1988, 31:1135-41.
• [12]Verstappen FTJ, van Santen-Hoefft HMS, Bolwijn PH, et al.: Effects of a group activity program for fibromyalgia patients on physical fitness and well-being. J Musculoskel Pain 1997, 5:17-28.
• [13]Minor MA, Sanford MK: The role of physical therapy and physical modalities in pain management. Rheum Dic Clin N Am 1999, 25(1):233-48.
• [14]Masi AT: An intuitive person-centred perspective on fibromyalgia syndrome and its management. Balliere's Clin Rheum 1994, 8:957-91.
• [15]Buskila D: Neuroendocrine mechanisms in fibromyalgia – chronic fatigue. Best Pract Res Clin Rheumatol 2001, 15(5):747-58.
• [16]Cohen ML, Quinter JL: Fibromyalgia syndrome: a problem of tautology. Lancet 1993, 342:906-8.
• [17]Kastrup J, Peteren P, Dejgard A, Angelo HR, Hilsted J: Intravenous lidocaine infusion – a new treatment of chronic painful diabetic neuropathy. Pain 1987, 28:69-75.
• [18]Rowbotham MC, Reisner-Keller LA, Fields HL: Both intravenous lidocaine and morphine reduce the pain of postherpetic neuralgia. Neurology 1991, 41:1024-8.
• [19]Sorenson J, Bengtsson A, Backman E, Henriksson KG, Bengtsson M: Pain analysis in patients with fibromyalgia. Effects of intravenous morphine, lidocaine and ketamine. Scan J Rheumatol 1995, 24:360-5.
• [20]Bennett MI, Tai YM: Intravenous lignocaine in the management of primary fibromyalgia syndrome. Int J Clin Pharm Res 1995, 15:115-9.
• [21]Jensen MP, Karoly P, Braver S: The measurement of clinical pain intensity: a comparison of six methods. Pain 1986, 27:117-26.
• [22]Jensen MP, Karoly P, Harris P: Assessing the affective component of chronic pain: development of the Pain Discomfort Scale. J Psychosom Res 1991, 35:149-54.
• [23]Edwards WT, Habib F, Burney RG, Begin G: Intravenous lidocaine in the management of various chronic pain states: a review of 211 cases. Regional Anaesthesia 1985, 10:1-6.
• [24]Sorensen J, Graven-Nielsen T, Henriksson KG, Bengtsson M, Arendt-Nielsen L: Hyperexcitability in fibromyalgia. J Rheumatol 1998, 5:152-5.
• [25]Gibson SJ, Littlejohn GO, Gorman MM, Helme RD, Granges G: Altered heat pain thresholds and cerebral event-related potentials following painful CO2 laser stimulation in subjects with fibromyalgia syndrome. Pain 1994, 58:185-93.
• [26]Lorenz J, Grasedyck K, Bromm B: Middle and long latency somatosensory evoked potentials after painful laser stimulation in patients with fibromyalgia syndrome. Electroencephalogr Clin Neurophysiol 1996, 100:165-8.
• [27]Mountz JM, Bradley LA, Modell JG, et al.: Fibromyalgia in women. Abnormalities of regional cerebral blood flow in the thalamus and the caudate ucleus are associated with low pain threshold levels. Arthritis Rheum 1995, 38:926-38.
• [28]Iadarola MJ, Max MB, Berman KF, et al.: Unilateral decrease in thalamic activity observed with positron emission tomography in patients with chronic neuropathic pain. Pain 1995, 63:55-64.
• [29]Jacobson NS, Truax P: Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. J Consult Clin Psychol 1991, 59:12-9.
• [30]Erskine A, Morley S, Pearce S: Memory for pain: a review. Pain 1990, 41:255-65.
• [31]Bryant RA: Memory for pain and affect in chronic pain patients. Pain 1993, 54:347-51.
• [32]Carr AJ, Thompson PW, Kirwan JR: Quality of life measures. Brit J Rheumatol 1996, 35:275-81.