Pain Quality Predicts Lidocaine Analgesia among Patients with Suspected Neuropathic Pain

Ian R. Carroll, MD, MS

Department of Anesthesiology
Stanford University School of Medicine
Palo Alto, CA

The expression and modulation of voltage-gated sodium channels are known to contribute to various animal models of neuropathic pain. Yet despite some evidence of efficacy, nonspecific sodium channel blockers—eg, lidocaine and carbamazepine—have failed to produce robust results in clinical trials, underscoring the need for improved therapeutics approaches. Some efforts are being made to target specific sodium channel isoforms expressed preferentially in primary sensory neurons, potentially widening the therapeutic window of this analgesic class. Others have sought to better identify responders to available sodium channel blockers among the heterogeneous population with neuropathic pain. Here Dr Carroll discusses using pain quality (eg, burning, aching) as an index of underlying heterogeneity in neuropathic pain to predict responsiveness to intravenous lidocaine.

References

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