RS1: A Multi-Centered Case Series Highlighting the Clinical Use and Dosing of Lidocaine and Mexiletine for Refractory Cancer Pain
Abstract
RS1: A Multi-Centered Case Series Highlighting the Clinical Use and Dosing of Lidocaine and Mexiletine for Refractory Cancer Pain Maureen L. Saphire, Rabia S. Atayee, Dharma Naidu, John Hausdorff, Kyle P. Edmonds and Jessica Geiger Background: Lidocaine infusion has been used for pain control for many years with beneficial effects. One study has shown that analgesic efficacy of lidocaine also predicts analgesic effects of mexiletine. While some institutions transition from continuous infusion lidocaine to oral mexiletine, guidance is lacking on an effective conversion method in pain and palliative care settings. Lidocaine is a commonly used local anesthetic and classified as a 1B anti-arrhythmic agent in a class of medications which also includes mexiletine. Lidocaine and mexiletine both have analgesic properties and have been predominantly studied for treatment of neuropathic pain. Specifically, lidocaine has been used for treatment of peripheral nerve injury, post-herpetic neuralgia, neuropathic cancer pain, diabetic neuropathy, fibromyalgia, and sickle cell pain. Methods: This is a retrospective case series of 10 cancer patients across four institutions, with attention to dosing of both lidocaine and mexiletine. The cases were compiled over an 18month period. The patients involved were adult hospitalized patients who were followed by the palliative care service and were receiving opioid therapy with concomitant IV lidocaine and subsequent oral mexiletine. The goal was to…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 10 participants or records.
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