You probably know lidocaine as the medication that is injected by the dentist to numb up your gums or numb a cut before you get stitches. Lidocaine is a medication that temporarily stops nerves from conducting signals or “talking” to each other. When we stop those signals, the nerves aren’t able to tell your brain that you have pain in that area. Additionally, lidocaine also has anti-inflammatory properties, meaning that while it’s most often used as a numbing agent, it can also reduce the cascade of inflammation cells released when the nerves are irritated. Another interesting fact about lidocaine is that when it is used as an infusion intraveneously, it can help “reset” the central network of nerves throughout our body (known as the central nervous system, or CNS), which includes our brain’s pain signals! This temporary reset of pain signaling combined with the anti-inflammatory effect of lidocaine can provide signficant relief for the pain of a migraine that just won’t go away.
What is the treatment like?
Lidocaine infusions are given through an IV and the medicine is delivered over about 1-2 hours (depending on the treatment protocol selected for you). Other medications may be added to help with reducing the migraine pain, such as Toradol. During the infusion, it is normal to feel numbness in your mouth, for your head to feel a little swimmy, and some people may feel nauseous. Anti-nausea medications will also be given to help with this. These side effects resolve shortly after the infusion is completed, and patients are monitored during and after the infusion for an additional 15-30 minutes for safety. As lidocaine can have effects on other areas of our body (like our heart rhythm), some patients will be asked to obtain an EKG prior to their first infusion. Lidocaine is not safe for people who have seizure disorders or an allergy to any of the “caine” numbing medicines. Otherwise, it is well-tolerated by most people.
