Effect of intravenous lidocaine combined with amitriptyline on pain intensity, clinical manifestations and the concentrations of IL-1, IL-6 and IL-8 in patients with fibromyalgia: A randomized double-blind study

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Effect of intravenous lidocaine combined with amitriptyline on pain intensity, clinical manifestations and the concentrations of IL-1, IL-6 and IL-8 in patients with fibromyalgia: A randomized double-blind study
Key Take-Away: 

Lidocaine/xylocaine/lignocaine is a drug used to numb the tissue in a specific area or loss of feeling for the patients who are undergoing medical procedures. The role of lidocaine combined with amitriptyline for analgesic efficacy has been studied efficiently here in this article.

Regarding the use of intravenous lidocaine in fibromyalgia, there are no well-controlled studies.

ABSTRACT: 
Background: 

Regarding the use of intravenous lidocaine in fibromyalgia, there are no well-controlled studies.

This study aimed 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.

Methods: 

In a randomized double-blind study, group 1 patients received 240 mg of lidocaine in 125 mL of saline solution, while group 2 patients received 125 mL of saline, both once a week for 4 weeks (T1, T2, T3 and T4).

All patients received amitriptyline. The 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.

Results: 

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.

Conclusion: 

The combination of 240 mg of intravenous lidocaine (once a week for 4 weeks) with 25 mg of amitriptyline for 8 weeks had no meaningful impact in fibromyalgia patients.

Int J Rheum Dis. 2016 Jun 16
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