Chye R

University of Technology Sydney

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Research Topics

Opioid Use Disorder Treatment (1) Pain Management and Opioid Use (1) Pain Management and Placebo Effect (1)

Lidocaine Infusion Publications

Feasibility and acceptability of "LiCPain" pilot randomised controlled trial of continuous subcutaneous infusion of lidocaine or placebo for people with neuropathic cancer pain: a qualitative study of patient and carer perceptions and experiences.

Lee JT, Agar M, Phillips JL, Rao A, Huang E , et al.
BMC palliative care •

BACKGROUND: Optimal intervention and clinical trial designs require consumer contributions. The experience of people with advanced cancer and palliative care needs in neuropathic pain trials is seldom reported. METHODS: This exploratory descriptive qualitative sub-study aimed to understand the experience of patients and carers participating in the Lidocaine for Neuropathic Cancer Pain (LiCPain) study, a pilot randomised controlled trial of continuous subcutaneous infusion of lidocaine hydrochloride or placebo over 72 h in people with unrelieved neuropathic cancer pain. All participants enrolled in the trial, conducted at five Australian palliative care inpatient sites, were intended to be invited to participate at the time of consenting to the main study. Reasons for not being invited, consenting to or completing the interview sub-study were not collected. A single face-to-face or telephone interview was audio recorded by the site study team nurses or doctors using a semi-structured interview guide. Data were analysed following Braun and Clarke thematic analysis approach. RESULTS: Out of 17 participants randomised to the LiCPain trial, seven participants and one carer consented to participate in the qualitative sub-study. Three major themes were identified: • Trial participation offered a sense of hope and purpose; • The impact of the intervention has multiple contributing factors; and • Pain impacts every aspect of life. CONCLUSIONS: Participants found hope and purpose in the Lidocaine for Neuropathic Cancer Pain trial. Contextual factors influenced perceived effectiveness. These findings will inform future intervention designs and clinical trials to improve outcomes for people experiencing unrelieved neuropathic cancer pain. TRIAL REGISTRATION: This trial was registered in the Australian New Zealand Clinical Trials Registry (ACTRN12617000747325) on 22nd May 2017.

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Lidocaine for Neuropathic Cancer Pain (LiCPain): A Pilot Randomized Controlled Trial.

Lee JT, Lovell MR, Ritchie M, Butcher BE, Sheehan C , et al.
Journal of pain and symptom management •

Extended continuous subcutaneous infusion of lidocaine for neuropathic cancer pain is currently used in clinical practice. To determine the feasibility of conducting an adequately powered, multisite, double-blind, parallel group, titrated dose, randomized controlled trial of continuous subcutaneous infusion of lidocaine versus placebo in palliative care patients with neuropathic cancer pain. Adults with neuropathic cancer pain were randomized to receive lidocaine hydrochloride 10%w/v (3000 mg/30 mL) diluted in sodium chloride 0.9% or sodium chloride 0.9% as a continuous subcutaneous infusion titrated daily for 72 hours. The dose increased from 1 to 2 mg/kg/h, capped at 120mg/hour (2800mg/day, rounded down). Seventeen participants were recruited over 54 months. There was a 93% [95%CI 88%-98%] completion rate of study medication and procedures meeting the predefined feasibility criteria. Eighty-eight percent of participants completed 72 hours of study medication. Treatment-emergent adverse events were infrequent and generally mild or moderate nervous system, cardiac and vascular abnormalities. There were no electrocardiogram abnormalities. Rapid titration from 1 to 2 mg/kg/h was tolerated. Both intervention and control groups demonstrated a reduction in pain intensity with no significant difference. This pilot demonstrates that a phase III clinical trial of extended continuous subcutaneous infusion of lidocaine for neuropathic cancer pain is feasible and provides important insights into modifications required to improve recruitment. Serum levels and relative safety suggest higher lidocaine doses could be cautiously evaluated. As the only prospective trial we are aware of to date, this trial informs clinical use of subcutaneous lidocaine infused over days.

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