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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effects of Lidocaine and the new local anaesthetic carticaine in spinal anaesthesia were compared in a double blind study in 120 elderly male patients scheduled for small urological procedures. The variables investigated were: analgesia examined by pin prick method, loss of tactile sensation, motor block, and skin temperature on the big toe. Both local anaesthetics seem to act similarly, but the loss of tactile sensation and motor block began somewhat earlier with carticaine. The differences have hardly any clinical significance. The incidence of hypotension and postanaesthetic headache was similar in each group.
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PMID:A comparison of carticaine and lidocaine in spinal anaesthesia. 36 Sep 57

Two cases are presented in which a 40-yr-old woman and a 20-yr-old woman developed severe headaches after injection of the local anesthetic Xylestesin-F (3% lidocaine with 1:25,000 norepinephrine). It is suggested that these severe headaches may have been associated with acute transient hypertensive episodes following injection of the local anesthetic. A review of the literature indicates that norepinephrine, at least at a concentration of 1:25,000, should be avoided because of its potential for cardiovascular disturbances.
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PMID:Adverse reactions associated with norepinephrine in dental local anesthesia. 130 79

Cocainization of the sphenopalatine fossa region has been shown to abort acute cluster headaches rapidly. Whether this response occurs by sympathomimetic action or via local anesthetic effect has been unknown. In this study, lidocaine hydrochloride was given as a therapeutic abortive agent to patients with cluster headache to elucidate cocaine's mechanism of action in relieving symptoms and to search for a safe, nonaddicting agent for self-administration. Using a 4% lidocaine solution applied to the sphenopalatine fossa, four of five patients obtained rapid relief of nitrate-induced cluster headaches and associated signs. Lidocaine was also effective in relieving spontaneous attacks. These results indicated that anesthetic rather than sympathomimetic effects are responsible for cocaine-medicated abortion of cluster headache, that transmission of pain in cluster headache likely occurs via the sphenopalatine fossa, and that topical lidocaine is effective in rapidly aborting acute cluster headache.
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PMID:Cluster headache. Local anesthetic abortive agents. 399 68

Nine patients suffered from intractable pain that was not relieved by analgesic medication. All had cancer of the stomach or pancreas. The coeliac plexus was approached from the back, two long Teflon catheters being directed onto the appropriate ganglia under x-ray control. When the catheters were correctly positioned, under continuous aspiration we administered via each catheter 25 ml of Xylocaine 0.5-0.8%. The successful and uneventful trial was followed with injection of an equal volume of 25 ml 50% alcohol through each catheter on the next day. In eight patients pain ceased completely while the ninth presented a 50% improvement. In the last five patients alcohol was injected 2 to 3 hours after the injection of the local anesthetic. We had a postspinal headache from accidental puncture of the dura mater, and a mild toxic reaction to Xylocaine. Also three patients presented hypotension after the Xylocaine was administered.
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PMID:[Infiltration block of the coeliac plexus using a plastic catheter]. 712 32

Chronic daily headache (CDH) is a particularly difficult type of headache to manage, with an uncertain pathophysiology. Intravenous administration of lignocaine has been suggested as a possibly useful option in the control of this syndrome. We have surveyed prospectively patients with CDH (selected for this study as those with 6 or more months of continuous pain with at least weekly exacerbations that, taken in isolation, would fulfil International Headache Society diagnostic criteria for migraine without aura). Intravenous lignocaine (2 mg/min) by infusion over a 2-day period rendered 26% of patients pain free, with a further 42% having at least a 50% improvement in the pain. Continued benefit was associated with commencement of prophylaxis with a tricyclic antidepressant or monoamine oxidase inhibitor after completion of the lignocaine infusion. In an animal model of craniovascular nociception, using electrical stimulation of the superior sagittal sinus and recording of single unit activity and sensory evoked potentials in the spinal trigeminal nucleus in the upper cervical spinal cord of the anaesthetised cat, the effect of lignocaine was examined. Lignocaine reduced both the probability of cell firing and the size of the trigeminal evoked potential in the animals studied. The reduction was both substantial (more than 25% in each case) and dose-dependent. Taken together the data suggest that CDH is likely to be a disorder of central craniovascular nociceptive control and that lignocaine acts to interrupt a part of the pathway involved but is unlikely to act at the central generator of the disorder.
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PMID:Lignocaine and headache: an electrophysiological study in the cat with supporting clinical observations in man. 793 41

Lidocaine is the first local anesthetic of the amide type to be introduced to clinical practice. It is a versatile drug and in anesthesia, is the most commonly used local anesthetic because of its aptness of potency, rapid onset, moderate duration of action and topical activity. It is relatively safe and useful in many other clinical settings. Unfortunately, systemic intoxication and psychotic reaction associated with its use often occur because of its popularity and wider safety margin, for which guide in use is often ignored and overdose becomes commonplace. Moreover, due to its universality in use seldom reports have recently dealt with lidocaine, particularly regarding its toxic reaction. Here, we present a case of lidocaine intoxication occurring during circumcision for a reviewal of the problem. A healthy young male, weighing 65 kg, underwent circumcision for phimosis under penile block with 2% lidocaine which totaled 600 mg. Twenty minutes after injection the patient developed headache, tinnitus, visual and auditory disturbances. Muscle twitching over the mouth angles, trismus and rigidity of extremities were also noted. Later in the course he became restless, agitative, hallucinative, talkative, and verbose with repetitious words. The whole course of the disorder lasted about 5 h. It was believed that lidocaine-induced CNS intoxication, manifested by psychotic reaction broke out. Treatment with thiopental was not very impressive. Also, we took this opportunity to discuss and review the toxic reaction associated with the use of lidocaine, its risk factors, mechanism, treatment and prevention. The complicated associations of lidocaine-induced CNS toxic reaction with central control of behavior and the neurotransmitter systems (adrenergic, dopaminergic and serotonin) were also touched.
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PMID:Lidocaine-induced CNS toxicity--a case report. 908 54

Spinal anaesthesia in the outpatient is characterized by rapid onset and offset, easy administration, minimal expense, and minimal side effects or complications. Spinal anaesthesia offers advantages for outpatient lower extremity, perineal, and many abdominal and gynaecological procedures. Development of small-gauge, pencil-point needles are responsible for the success of outpatient spinal anaesthesia with acceptable rates (0-2%) of postdural puncture headache (PDPH). Compared with peripheral nerve blocks, spinal anaesthesia has a more predictable offset. There are many possible choices of local anaesthetics for outpatient spinal anaesthesia. These include lidocaine, prilocaine, mepivacaine and small doses of bupivacaine. Meperidine has local anaesthetic properties in addition to its opiate properties. It has been used as the sole intrathecal agent for spinal anaesthesia but has no real advantages over lidocaine. Mepivacaine and lidocaine have each been associated with transient neurological symptoms (TNS) following intrathecal administration. This has stimulated development of alternative agents, including combinations of local anaesthetics and opioids. Lidocaine remains the most useful agent for outpatient spinal anaesthesia. For longer procedures, mepivacaine is an excellent spinal anaesthetic agent. Attention to technique, reduction of dose and addition of fentanyl to lidocaine result in effective spinal anaesthesia with rapid recovery and a low incidence of significant side effects or complications.
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PMID:Spinal anaesthesia for outpatient surgery. 1452 6

Most neuropathic analgesic medications have been introduced initially for other medical conditions. Anticonvulsants, local anesthetics, and antidepressants later were found to be effective in the treatment of neuropathic pain. Carbamazepine and the newer anticonvulsants such as gabapentin, lamotrigine, topiramate, and oxcarbazepine are being used as first-line or adjunctive therapy. The newer agents have less potential for drug interactions and a more favorable side-effect profile. Lidocaine administered systemically or topically is useful for some peripheral and central neuropathic pain conditions. The tricyclic antidepressants amitriptyline, nortriptyline, and desipramine have been shown to be effective for the management of neuropathic pain, independent of their antidepressant property. All of the available analgesics have considerable side effects, which necessitate careful titration. Future drug research may focus on developing medications specifically for neuropathic pain. These designer agents may have more desirable action without the unwanted side effects.
Curr Pain Headache Rep 2004 Feb
PMID:Current pharmacologic approaches to treating neuropathic pain. 1473 78

A 44-year-old man with a past medical history of episodic cluster headache presented in our ED with complaints of multiple daily cluster headache attacks, with cervico-occipital spreading of pain from May to September 2004. The neurological examination showed no abnormalities as well as brain and spine MRI. Great Occipital Nerve (GON) blockade, with Lidocaine 2% (5 ml) and betamethasone (2 mg), were performed in the right occipital region (ipsilaterally to cluster headache), during attack. GON blockade was effective immediately for the attack and the cluster period resolved after the injection. We suppose that the action of GON blockade may involve the trigemino-cervical complex and we moreover strongly suggest to use GON blockade in emergency departments for cluster headache with cervico-occipital spreading as attack abortive therapy, especially in oxygen and sumatriptan resistant cluster headache attacks, in patients who complaints sumatriptan side-effects or have contraindications to use triptans.
J Headache Pain 2006 Apr
PMID:Great occipital nerve blockade for cluster headache in the emergency department: case report. 1668 13

Lidocaine is a use-dependent sodium channel blocker that produces analgesia when administered intravenously to patients with neuropathic pain. This article reviews the role and limitations of intravenous lidocaine infusions for neuropathic pain. Lidocaine infusions rarely provide relief that persists significantly beyond the duration of the infusion. Diagnostically, systemic lidocaine may help establish the presence of neuropathic pain and the responsivity to oral sodium channel blockade. However, the data supporting diagnostic infusions remain sparse. Therapeutically, infusions should generally be restricted to patients with neuropathic pain who are unable to take oral medication.
Curr Pain Headache Rep 2007 Feb
PMID:Intravenous lidocaine for neuropathic pain: diagnostic utility and therapeutic efficacy. 1721 17


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