Master Clinician Series

“This Pain is Mind-Numbing”: Use of Intravenous Lidocaine in Refractory Pain

April 3, 2018 at 3:00 p.m. ET

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About the event

68yo male with metastatic pancreatic cancer, metastases eroding into the sacral plexus. Could not tolerate lying flat for any period of time, including receiving palliative radiation, which had been very effective for pain management in the past. Was receiving a hydromorphone PCA with a basal rate as well as a bolus dose, max dose gabapentin, ketorolac, ketamine and venlafaxine for pain along with scheduled lorazepam for anxiety associated with the radiation treatments. Could not get on the table for the first treatment and had to stop the second treatment early, both due to intolerable pain. Initiated a lidocaine challenge dose followed by a continuous infusion in an effort to make the radiation treatments tolerable. This was successful and he was subsequently converted to oral mexilitine.

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Presented by

Jessica Geiger-Hayes PharmD, BCPS, CPE
Charles F. von Gunten, MD

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