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.
OBJECTIVE
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.


CONCLUSIONS
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.
Department of Anesthesia, Federal University of São Paulo, São Paulo, Brazil.
Ana Laura
AL
Albertoni Giraldes
Department of Anesthesia, Federal University of São Paulo, São Paulo, Brazil.
Reinaldo
R
Salomão
Department of Anesthesia, Federal University of São Paulo, São Paulo, Brazil.
Plinio da Cunha
PD
Leal
Department of Anesthesia, Federal University of São Paulo, São Paulo, Brazil.
Milena Karina Coló
MK
Brunialti
Department of Anesthesia, Federal University of São Paulo, São Paulo, Brazil. rsakata@unifesp.br.
Rioko Kimiko
RK
Sakata
D061605:Administration, Intravenous; D000328:Adult; D000639:Amitriptyline / Q000008:administration & dosage* / Q000009:adverse effects; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D001938:Brazil; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005356:Fibromyalgia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007375:Interleukin-1 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D008012:Lidocaine / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D010147:Pain Measurement; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D000779:Anesthetics, Local; D015415:Biomarkers; C508606:CXCL8 protein, human; C508600:IL6 protein, human; D007375:Interleukin-1; D015850:Interleukin-6; D016209:Interleukin-8; D000639:Amitriptyline; D008012:Lidocaine
fibromyalgia; interleukin 1, 6, 8; intravenous; lidocaine; neurotransmitters