Efficacy of subcutaneous lidocaine injection in venous insufficiency: a prospective, randomized, controlled study, and new treatment protocol.
Bahar Dernek, Levent Adiyeke, Tahir Mutlu Duymus and 3 others
PMID 29950758WHAT IT FOUND
Adding subcutaneous lidocaine to ankle pumping, compression stockings, gabapentin, and calcium dobesilate lowered pain and quality-of-life impairment scores at 1, 3, and 6 months.
At 1 year, the groups did not differ.
Key findings
01At 1, 3, and 6 months, VAS pain scores were lower in the lidocaine group than in the control group. At 1 year, the groups did not differ.
02CIVIQ-20 quality-of-life impairment scores were lower in the lidocaine group than in the control group at 1, 3, and 6 months. At month 12, the groups did not differ.
03Patients also received ankle pumping exercises, above-knee compression stockings, oral gabapentin, and calcium dobesilate, so the study cannot separate the contribution of any single component.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study enrolled only women with CEAP stage 1 or 2 CVI who were not considered for surgery. The treatment group had a higher proportion of stage II CVI than the control group at baseline. 20 patients did not continue treatment or were lost to follow-up. 100 patients were evaluated at the 12-month follow-up. Patients received multiple treatments together: lidocaine, ankle pumping exercises, above-knee compression stockings, oral gabapentin, and calcium dobesilate. The paper cannot separate the contribution of any single component. The authors state that reduction in leg edema could not be detected objectively. The authors state that follow-up ultrasonography was not performed. The authors state that biochemical markers such as P-selectin were not measured.
Declared interests
The paper states that funding was none and conflicts of interest were none.
The easy way to misread this
Do not read the 1 to 6 month benefit as proof that lidocaine alone works. The injections were given with ankle pumping exercises, above-knee compression stockings, oral gabapentin, and calcium dobesilate, and the lidocaine group had more stage II disease at baseline. Do not read the benefit as lasting to 1 year, because the groups did not differ at 1 year.