Evaluation of the Role of Intravenous Lidocaine Infusion in the Management of Chronic Pain: A Retrospective Study.

BACKGROUND

Intravenous lidocaine infusion is increasingly used in chronic pain services; however, real-world data regarding durability of analgesic benefit and safety in routine practice remain limited.

OBJECTIVE

To evaluate patient-reported analgesic outcomes, duration of benefit and safety profile of intravenous lidocaine infusion in a tertiary chronic pain service.

METHODS

A retrospective service evaluation was conducted at Leicester General Hospital, pain management department, including all adult patients who received intravenous lidocaine infusion between October 2024 and March 2025. Lidocaine was administered at 3 mg/kg over 1 h under monitored day-case conditions. Patients were contacted by structured telephone follow-up to assess Numerical Rating Scale (NRS) pain scores, duration of benefit, adverse effects and satisfaction. Descriptive statistics were used to summarise outcomes.

RESULTS

Of 136 treated patients, 112 completed follow-up (82.4%). Mean baseline NRS decreased from 8.0 to 4.5 during the early posttreatment period, representing an absolute reduction of 3.5 points. More than 60% of patients reported clinically meaningful improvement, while sustained pain relief beyond 3 months was reported by 29% of patients. Adverse effects occurred in 17% of cases and were mild and self-limiting, with no serious adverse events observed. Overall satisfaction with treatment was high, with 85% of patients indicating that they would recommend intravenous lidocaine infusion for chronic pain management. Among these, 47% were receiving the infusion for the first time.

CONCLUSION

In this real-world cohort, intravenous lidocaine infusion was associated with short- to medium-term patient-reported pain improvement and a favourable safety profile. While a subset experienced sustained benefit beyond 3 months, most patients reported shorter duration relief. Prospective controlled studies using validated outcome measures are required to define long-term efficacy and optimal patient selection.