Intrathecal pump delivery system can be used as reservoir, for intermittent iv lidocaine for the treatment of neuropathic flank pain.

摘要

IV Sodium Channel blockers are known to be effective in the treatment of resistant neuropathic pain. We present a case where the Synchromed II? delivery system, usually utilized for intrathecal therapy, is used for the treatment of neuropathic pain with intermittent IV lidocaine boluses.IV lidocaine has been used in the treatment of pain disorders for years. The primary mechanism of action of lidocaine is believed to be related to blocking of voltage-gated sodium channels [1]. Local anesthetics may have many other actions when given systemically, which can explain their effectiveness in pain. Anesthetics appear to act at opioid receptors too [2]. Animal models of peripheral nerve injury suggest that the ectopic discharges that occur after injury and are conducted along sodium channels are suppressed with lidocaine with no effect on normal nerve conduction [3]. To our knowledge, intravenous lidocaine has been used as continuous infusion, repeated continuous infusions but not as single long term therapy with intermittent PCA (patient controlled analgesia) boluses to treat neuropathic pain. This article describes a therapeutic option we choose in a patient suffering extremely severe neuropathic flank pain.