Combination of intravenous lidocaine and amitriptyline in fibromyalgia
Fibromyalgia is a chronic disorder characterized by unexplained pain in the muscles and joints. It is not a disease, but a syndrome, which is a collection of symptoms that occur together. The condition is often associated with tender points, which are termed “trigger points. There is no cure available for fibromyalgia, but there are treatments that relieve from the symptoms. There are no good studies done regarding the use of intravenous lidocaine in fibromyalgia.
So, the study was conducted to evaluate the effect of intravenous lidocaine on pain intensity, clinical manifestations and plasma levels of interleukin (IL)-1, IL-6, and IL-8 in fibromyalgia patients.
In the conducted randomized double-blind study, group 1 patients received 240 mg of lidocaine in 125ml of saline solution, while group 2 patients received 125ml of saline both once a week for 4 weeks (T1, T2, T3 and T4). Amitriptyline was given to all the patients. In this trial, following were assessed: pain intensity before treatment (T0) and at 1, 2, 3, 4 and 8 weeks after treatment; clinical manifestations; the fibromyalgia impact questionnaire (FIQ) before and at 4 and 8 weeks after the levels of IL 1, 6 and 8 before and at 4 and 8 weeks after treatment.
After the analysis, lower pain intensity was observed in the lidocaine group at T2 with no difference at the other time points. There was a reduction in pain intensity in both groups. The use of paracetamol and tramadol and plasma levels of IL-1, IL-6 and IL-8 did not differ between the groups. Clinical manifestations and side effects did not differ between groups. It was derived that this combination intravenous lidocaine with amitriptyline had no effect in fibromyalgia patients.