Intravenous infusion therapy for the management of pain conditions

January 08, 2015
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Intravenous Infusion Therapy

Intravenous (IV) infusion therapy is an exciting treatment option for numerous pain syndromes ranging from fibromyalgia and small fiber neuropathy to Complex Regional Pain Syndrome (CRPS) and Reflex Sympathetic Dystrophy (RSD). IV infusion therapy is very simple: an IV line is placed in the patient’s arm and the medication flows in.

There are several medications that are commonly delivered IV for pain management:

• Lidocaine
• Ketamine
• Immunoglobulin (IG)
• Clonidine
• Dexmedetomidine
• Bisphosphonates
• Magnesium

These medications are typically mixed with saline in an IV bag and slowly infused accordingly based on the medication and/or protocol being utilized.

Procedure Overview

Patient Looking At Nurse While Receiving Intravenous Treatment I

Dr. Hanna will first select the appropriate medication to be used in the infusion depending on the type of pain that you are experiencing. Next, the office staff will weigh you to determine the proper amount of medication needed and mix it with saline in an IV bag. Next, Dr. Hanna will place an IV line in your arm or hand per standard IV protocols. The medication is infused through the IV over variable times depending on the medication. It’s that simple. During the infusion process, you will be placed on a monitor and your vitals will be closely observed for the duration of the infusion.

Medication Overview

Lidocaine – Blocks sodium channels in the neuronal cell membrane that may potentially play a role in the pathogenesis and maintenance of both neuropathic and inflammatory pain

Ketamine – N-methyl-D-aspartate (NMDA) Receptor antagonist – therefore decreases sustained neuronal depolarization and excitatory transmission along afferent pain pathways in the dorsal horn of the spinal cord

Immunoglobulin (IG) – Counteracts neuroinflammation by inhibiting complement deposition, neutralizing cytokines and growth factors, speeds up clearance of potentially pain-inducing auto-antibodies, and activation of macrophages and T cells through FcγRIIb receptor

Clonidine – α2-adrenergic receptor agonist believed to reduce of norepinephrine release from the α2-adrenergic in the periphery

Dexmedetomidine – Selective α2-adrenergic agonist that may have a role in treating painful conditions that are manipulated and/or attenuated by the sympathetic nervous system

Bisphosphonates – Decreases neuropathic bone pain by suppressing bone resorption via osteoclast inhibition, shortens osteoclast life span and decreasing the acidity of the local microenvironment

Magnesium – Competitive NMDA receptor antagonist that decreases acute and chronic pain by stabilizing abnormal nerve excitation

How Many Treatments are Required?

The response to treatment varies patient by patient. Most require several treatments; the amount required depends on the medication and the protocol being used. Some people respond at first infusion, but most will not feel the full benefit until several treatments have been administered.

Is Infusion Therapy Right for me?

If you suffer from chronic pain that has not responded to medication or other traditional treatment options, then infusion therapy may be an option for you.

To make an appointment today with Dr. Hanna, call 727-797-7463.