Intravenous infusion tests have limited utility for selecting long-term drug therapy in patients with chronic pain: A systematic review

Steven P. Cohen, Shruti G. Kapoor, James P. Rathmell

Research output: Contribution to journalReview articlepeer-review

Abstract

Since the first description in the early 1990s, the scope of intravenous infusions tests has expanded to encompass multiple drug classes and indications. Purported advantages of these tests include elucidating mechanisms of pain, providing temporary relief of symptoms, and usefulness as prognostic tools in guiding drug therapy. In an attempt to discern the value of these tests, the authors conducted a systematic review to explore the rationale and evidence behind the following intravenous infusion tests: lidocaine, ketamine, opioid, and phentolamine. The studies evaluating all intravenous infusion tests were characterized by lack of standardization, wide variations in outcome measures, and methodological flaws. The strongest evidence found was for the intravenous lidocaine test, with the phentolamine test characterized by the least convincing data. Whereas intravenous opioid infusions are the most conceptually appealing test, their greatest utility may be in predicting poor responders to sustained-release formulations.

Original languageEnglish (US)
Pages (from-to)416-431
Number of pages16
JournalAnesthesiology
Volume111
Issue number2
DOIs
StatePublished - Aug 2009

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Fingerprint Dive into the research topics of 'Intravenous infusion tests have limited utility for selecting long-term drug therapy in patients with chronic pain: A systematic review'. Together they form a unique fingerprint.

Cite this