Article ; Online: Lidocaine infusion for malignant visceral pain: case report.
BMJ supportive & palliative care
2024 Volume 13, Issue e3, Page(s) e974–e976
Abstract: Background: Visceral pain accounts for nearly 28% of cancer-related pain, and its effective management poses significant challenges. The diverse pathways of neurotransmission, neurotransmitters, channels, and receptors suggest the need for ... ...
| Abstract | Background: Visceral pain accounts for nearly 28% of cancer-related pain, and its effective management poses significant challenges. The diverse pathways of neurotransmission, neurotransmitters, channels, and receptors suggest the need for individualized analgesic therapy. Our objective is to explore a therapeutic alternative for managing malignant visceral pain in advanced cancer. Cases: In this report, we present two patients with malignant bowel obstruction and severe visceral pain, despite receiving opioid treatment, necessitating an alternative approach. Surgical interventions were considered but promptly ruled out. Paracentesis was performed as necessary. Pain management was initiated using a combination of opioids and co-analgesics. However, both patients required opioid dose escalation without achieving adequate pain control or tolerating the associated side effects. Consequently, a lidocaine infusion was administered to alleviate pain. Outcome: Following 24-48 hours of lidocaine infusion, both patients achieved satisfactory symptom control, enabling a reduction in opioid doses and improvement in intestinal transit. No side effects were reported during the treatment. Discussion: Lidocaine infusions may be beneficial for pain management in patients with malignant bowel obstruction and visceral pain. The extent of pain control achieved in comparison to other therapeutics remains challenging to ascertain. We posit that lidocaine infusions, with their potential impact on visceral hypersensitivity, can enhance pain control and facilitate the recovery of bowel transit. Further studies are warranted to validate these findings. |
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| MeSH term(s) | Humans ; Analgesics ; Analgesics, Opioid/therapeutic use ; Lidocaine/therapeutic use ; Pain Management ; Visceral Pain/drug therapy ; Visceral Pain/etiology |
| Chemical Substances | Analgesics ; Analgesics, Opioid ; Lidocaine (98PI200987) |
| Language | English |
| Publishing date | 2024-01-08 |
| Publishing country | England |
| Document type | Case Reports ; Journal Article |
| ISSN | 2045-4368 |
| ISSN (online) | 2045-4368 |
| DOI | 10.1136/spcare-2023-004350 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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