Study: Lidocaine infusions may ease tough-to-treat migraines

An intravenous infusion of the local anesthetic lidocaine appears to offer some pain relief to patients battling otherwise untreatable daily migraines.

That’s the takeaway from a new study that examined the effectiveness of lidocaine infusion treatment — a much debated therapy that requires a hospital stay — as a means to address “refractory chronic migraines,” or rCM.

A diagnosis of rCM means patients have suffered at least eight migraines a month for a minimum of six months without responding to standard treatment and prevention strategies.

Those first-line treatments include standard painkillers and beta blockers; corticosteroids; antidepressants; anti-convulsants; calcium blockers; Botox injections, and/or noninvasive electrical stimulation.

“Lidocaine is a local anesthetic — a numbing medicine — but also reduces inflammation in studies,” said study author Dr. Eric Schwenk, director of orthopedic anesthesia at the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia.

The findings suggest that chronic migraine patients experienced pain relief for about a month after hospital treatment with IV medications including lidocaine, he said.

Between 1% and 2% of the population get the chronic migraine headaches.

The researchers looked at hospital records for just over 600 patients, most of them women.

All had been admitted to a Philadelphia hospital between 2017 and 2020 for lidocaine infusion treatment.

Prior to treatment, patients had experienced moderate to severe headaches for about 27 out of every 30 days.

Lidocaine infusions were initially started at 1 mg per minute, then increased up to 4 mg per minute. At a follow-up appointment 25 to 65 days later, patients reported that on average, they had headaches on 23 of the last 30 days — four fewer than before treatment.

The findings were published in the journal Regional Anesthesia & Pain Medicine.

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