Results of a study reveal that lidocaine infusions could provide some pain relief to individuals suffering from chronic migraine not responding to other treatment options.1✅ JOURNAL REFERENCE
DOI: 10.1136/rapm-2021-103180
Making use of local anesthetics like lidocaine infused intravenously has been proposed as a potential treatment option for individuals with a poor quality of life as a consequence of chronic migraine which is unresponsive to treatment. The goal is to ’break the cycle’ of pain, but there has been little research examining the efficacy of this treatment apart from immediate relief of pain.
This retrospective study analyzed the hospital records of 609 individuals who had been admitted with unresponsive chronic migraine and were then treated with lidocaine infusions to evaluate the short-term as well as medium-term benefits of this method. Individuals included in the analysis had experienced at least 8 days each month of debilitating headaches for a minimum of 6 months and either failed to respond to or experienced contradictions to the 7 migraine classes of medicine.
The participants received infusions of lidocaine over several days together with other aggressive migraine drug treatments, which included neuroleptics, methylprednisolone, dihydroergotamine, magnesium, and ketorolac.
The majority of individuals experienced rapid relief of pain. The average rating given by participants was 7.0 when admitted and this was reduced to 1.0 by the time they were discharged from the hospital.
Individuals participating in follow-up visits approximately 1 month after being discharged also reported the amount of days experiencing headaches had decreased. The 266 individuals attending these visits, which happened between 25 and 65 days after being discharged, noted that the amount of days with headaches in the last month had gone down from an average of 26.8 to 22.5.
Although nausea and vomiting were experienced by some individuals throughout the treatment, all negative events they experienced were slight.
Because this was an observational study, cause can’t be established and some limitations were noted by the researchers. Most significantly, not all participants completed follow-up visits, although these were probably individuals who had responded well. Also, some individuals were included more than once in the analysis due to the fact they had been admitted on more than one occasion, and although unlikely, hospitalization itself may have been a contributing factor to the relief of pain.
Continuous lidocaine infusions were linked to acute pain improvement in most individuals and a reduction in average pain as well as the amount of headache days each month extending out to 1 month. The majority of individuals were acute responders, with 43% of them sustained responders maintaining improvement at 1 month.
According to the researchers, lidocaine could be a potential treatment option for sufferers of unresponsive chronic migraine who haven’t had success with other treatment options.
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