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Amir Aslam, Jaipaul Singh and Satyan Rajbhandari
Objective: This study assessed the efficacy of lignocaine infusion as a treatment for painful diabetic neuropathy (PDN) groups compared to chronic pain (non-PDN group) in challenging cases where conventional treatment is not helpful.
Methods: A total 11 patients participated in the study with 7 patients referred from pain clinic (non-PDN group) and 4 for patients referred from diabetic foot clinic (PDN group) for lignocaine infusion as a treatment for chronic pain. Both groups of participants were on multiple combination of pain medication with minimal help. All the subjects gave consent for participation and filled out McGill short form (SF) questionnaire before and after the lignocaine infusion.
Results: The results show 33% reduction of visual analogue pain score after lignocaine infusion in PDN group compared to 11% reduction of visual analogue pain score in non-PDN group. These data were statistically significant (p<0.05). Similarly, there was a significant (p<0.05) reduction of affective pain score with 41% after lignocaine infusion in PDN group compared to 21% in non-PDN group. In contrast, the sensory pain score reduction after lignocaine infusion was 23% in PDN group compared to 17% in non-PDN group. These data were statistically not significant (p>0.05). All 11 patients had no reported adverse effects and their observations were in normal limits throughout the lignocaine infusion.
Conclusion: Overall, the study showed that lignocaine infusion is both effective and safe in reducing chronic intractable pain when conventional treatments are intolerable or not helpful. It is more effective in painful diabetic neuropathy patients compared to other causes of chronic pain.