HF 5314

Starting Intravenous (IV) Lidocaine for Pain in the Hospital

Lhis handout tells you what to expect when starting IV lidocaine treatment. Lidocaine is a medicine that numbs the skin and treats some heart conditions. It can also help with pain by slowing pain signals or calming damaged nerves.

Benefits

The infusion may help to:

  • Lower your pain to a more manageable level

  • Decrease the number of pain medicines you take

  • Increase your ability to do activities

Pain

Talk with your care team about any concerns about your pain treatment. Explain how pain affects your daily life. Rate your pain on a scale of 0 to 10 (0 = no pain, 10 = worst pain). You may also describe your pain as mild, moderate, or severe.

Safety Testing

Lidocaine is a safe treatment for most people. To make sure it is safe for you, your doctor will order an electrocardiogram (ECG) to check your heart rhythm.

Your doctor may also order a lidocaine trial. If there are abnormal results, we will review it with you before moving forward.

Medicine

Tell your doctor what medicines you are taking for other health problems. We need to know because mixing some drugs with pain medicines can cause problems.

Pregnancy

If you are pregnant, breastfeeding, or planning to be pregnant, please tell your care team. Lidocaine infusions are not safe if you are pregnant.

Diet

Patients may eat and drink normally on the day of infusion. All medicines can be taken as prescribed.

What to Expect During the Trial

Your nurse will place an IV in your arm. The lidocaine will be given over 1 hour (adults) or 1½ to 2 hours (pediatrics). Tell your nurse about any side effects, even if they seem small. The nurse may slow or stop the infusion if needed. You will be monitored during the trial and for 30 minutes after.

We will try to keep you as comfortable as possible. Feel free to bring something to read or a tablet/iPad with headphones.

Side Effects

As with any medicine, there is always a chance that you may have side effects. These tend to be mild and go away once the infusion is slowed or stopped. However, some patients may have side effects that last for many hours. Most side effects will be gone by the time you leave. Side effects include:

  • Drowsiness

  • Lightheadedness or feeling dizzy

  • Tongue heaviness or slurred speech

  • Nausea (this can be reduced by eating before the infusion)

  • Numbness/tingling around the mouth

  • Headache

  • Blurry or double vision

  • Ringing in your ears or tunnel hearing

  • Metallic taste in your mouth

Serious side effects are rare but can happen. These include:

  • Low or high blood pressure

  • A slow or fast heart rate

  • Abnormal heartbeats

  • Fainting

  • Seizures

  • An allergic reaction (very rare, life-threatening)

If you get a continuous infusion, learn the side effects and report them right away to your care team.

After Your Infusion

Here’s what to expect after your lidocaine infusion and what happens next.

Recovery time: You will stay for 15–30 minutes so we can check your vital signs. You may feel drowsy or confused. Please arrange for someone to drive you home. If you are staying in the hospital, your care team will check on you within 24 hours. They will decide if the test dose worked and if more treatment is needed.

Side effects: If you have side effects, the nurse will stop the infusion. If symptoms continue, we may take a blood sample. Mild side effects are an early warning of too much lidocaine, so pay close attention to the list we gave you. Most side effects go away within an hour, but some may last longer. Talk to your care team before restarting treatment.

Ongoing treatment: If you need a continuous infusion, it may take 2–3 days to find the right dose. Most patients need treatment for at least a few months.

At home: When at home, be prepared to have your lidocaine level drawn if needed.