Lidocaine IV infusion to treat pain

Lidocaine is a local anaesthetic used to numb a particular area. Infusion means it is a fluid.

For this treatment, we give you lidocaine into a vein (intravenously) using an automated pump. A small tube (cannula) will be put into your arm or the back of your hand, to give you the medicine.

Lidocaine is prescribed for some people who have:

  • widespread, long-term (chronic) pain
  • persistent (refractory neuropathic) pain
  • short and painful (cluster) headaches

Taking an unlicensed medicine

Lidocaine is not officially approved (licensed) to be used in this way, but it is widely used, and known to reduce pain for some patients.

Read our information about unlicensed medicines. You can also call our pharmacy medicines helpline, phone 020 7188 8748, Monday to Friday, 9am to 5pm email [email protected]

How lidocaine works

It works by lowering nerve activity, reducing inflammation (swelling), and adapting nerve signals. This means that it calms down the nerves, which reduces the pain.

Benefits of this treatment

You might find a decrease in pain, from severe to a more manageable level. You might be able to reduce the amount of painkillers you regularly take, and you might be able to do more activities. Unfortunately, we cannot guarantee that you will benefit from this treatment.

Side effects of a lidocaine infusion

Serious side effects or complications are very rare. We monitor you throughout the treatment to reduce the risk of any problems. However, even when we give you the correct amount (dose), side effects can happen. These include:

  • dizziness
  • headaches
  • sleepiness
  • tingling or numbness around your mouth
  • metallic taste
  • garbled speech
  • tunnel vision
  • ringing in your ears
  • a tremor (shaking or trembling you cannot control)
  • a feeling of being drunk or sick (nauseous)

If you have any of these side effects, they usually disappear when the infusion is slowed down or stopped.

Possible complications of lidocaine infusions include:

  • low or high blood pressure
  • a slow or fast pulse rate
  • irregular heartbeat
  • fainting
  • seizures or fits
  • allergic reactions

In extremely rare cases, the complications may be serious, and can cause death.

Preparing for the infusion

  • Do not eat any food for 6 hours before your admission time.
  • You can drink water and black coffee (no milk) until 2 hours before your admission time.
  • Continue to take all your medicines as usual unless our doctor tells you not to.
  • Bring a list of all of your medicines with you to your appointment.

It is very important that you tell us if you’ve had any recent heart, liver or kidney problems. This includes:

  • irregular heartbeats
  • abnormal ECGs
  • seizure disorders
  • previous reactions to local anaesthetic

We recommended that you do not have this infusion if you are, or think you might be, pregnant. If you are of child-bearing age, you will be asked to take a pregnancy test.

The day of the treatment

Before we start the treatment, we will confirm that you have followed the instructions about eating and drinking, as this treatment can make you feel sick.

We will check your height and weight and, if it’s the first time you’re having this infusion, you will have an ECG too.

We will insert a small plastic tube (cannula) into the back of your hand, and we might need to take some blood for routine screening tests.

During treatment

You will be monitored throughout the infusion, and for 30 minutes afterwards. We will be recording you heart rate, blood pressure and oxygen levels every 15 minutes. The infusion usually takes 1 to 2 hours.

You can leave the hospital when we are confident that you have not had any significant side effects.

The treatment takes between a few weeks and several months to work, so you will not know on the day of treatment how effective it has been.

After the infusion

You can usually resume normal activities after the procedure, unless your doctor tells you otherwise.

It’s OK to restart your exercise or physiotherapy as soon as you feel comfortable doing so.


  • do complete your pain questionnaires as asked (this is how we will know if your treatment has worked)
  • do continue to take your regular medicines, including painkillers, anti-inflammatory medicines and any that thin your blood
  • do monitor yourself for any symptoms of infection


  • do not drive or operate heavy machinery for at least 24 hours

When to get help

It is rare to get an infection after a procedure.

Follow-up appointments

You will have a phone or face-to-face follow-up appointment 2 to 3 months after the treatment, to check how helpful it has been. We might offer repeat treatments if it is considered effective.

Your consultant will decide how often you can have the treatment, based on the amount of pain relief that you get.

If the treatment does not help your pain, try not to worry. Talk to your consultant as there might be other treatment options for you.

Other treatment options

Alternative options might include different medicines, injections or physical therapies. These will need to be discussed in more detail with your consultant.

Contact us as soon as possible if you have:

  • high temperature (fever) or shivering
  • severely increased pain
  • redness
  • any drainage from the injection site

Specialist nurses, phone: 020 7188 4714, Monday to Friday, 9am to 5pm.

Outside hours contact your GP or phone 111.

In an emergency, go immediately to your nearest emergency department (A&E) or phone 999.

Resource number: 5376/VER1
Date published: November 2023
Review date: November 2026

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