Effects and predictors of intravenous lidocaine infusion for patients with fibromyalgia
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Objective
Fibromyalgia is a chronic pain condition characterised by widespread pain, fatigue, and cognitive function impairment. The current treatment primarily focuses on self-management and symptomatic relief. IV lidocaine infusion is the most performed procedure in the UK that is offered after conventional therapy has failed. We aimed to identify predictors of response to systemic lidocaine to enable targeted treatment for individuals more likely to benefit.
Methods
It was a retrospective study at a tertiary pain centre. Adult patients who have completed questionnaires and quantitative sensory testing (QST) before IV lidocaine infusion were included. We collected data from 132 patients, including 24 men and 108 women. Responders were defined as patients who experienced a pain reduction of 50% or greater lasting for at least three weeks following an IV lidocaine infusion at a dose of 5 mg/kg.
Results
We identified 22% of patients as responders. Our findings indicate a notable gender disparity in the number of responders, with a response rate of 25.9% observed in female compared to 4.2% in male patients. There was no significant difference in demographic characteristics, pain severity, and sleep interference between male and female patients, except for a higher score in functional impairment among females. Responders were younger, had shorter pain duration, and had lower weekly pain scores. No significant difference in QST parameters or loss/gain phenotypes was observed between responders and non-responders.
Conclusions
IV lidocaine infusion proves effective, especially for younger female patients. It should be added to conventional therapies for these patients. More research is needed on gender differences and fibromyalgia subtypes.
