Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20230086-en
Brazilian Journal of Pain
Case Report

Use of intravenous lidocaine in a patient with refractory chest pain secondary to Takayasu arteritis. Case report

Uso da lidocaína endovenosa em paciente com dor torácica refratária secundária à arterite de Takayasu. Relato de caso

Leandro Barros da Silva; Barbara Caroline Silva de Siqueira; Gustavo Luiz Behrens Pinto; Antonio Argolo de Sampaio Filho; Julie Azevedo Araújo Valente

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Abstract

BACKGROUND AND OBJECTIVES: Takayasu’s arteritis (TA) is a rare form of chronic inflammatory disease involving large vessels, with uncertain etiology, with chest pain as a common and challenging symptom, resulting from inflammation in the aortic root or arch, pulmonary artery or coronary arteries. The objective of this study was to describe the use of intravenous lidocaine to treat severe and refractory chest pain secondary to TA.
CASE REPORT: A 33-year-old female patient diagnosed with TA, with severe chest pain that was difficult to manage, was admitted after consulting an emergency department. The pain was unresponsive to traditional treatment after a week of drug adjustments. As a therapeutic option, a Sympathetic Venous Blockade (SVB) with lidocaine was chosen, achieving a reduction in pain from 10 to 3 on the Visual Analog Scale. Infliximab was administered before discharge. The patient was re-evaluated at an outpatient appointment after 30 days.
CONCLUSION: This strategy for the treatment of severe chest pain allowed for pain reduction and relief.

Keywords

Case report, Chronic pain, Intractable pain, Lidocaine, Local anesthetics, Takayasu arteritis

Resumo

JUSTIFICATIVA E OBJETIVOS: A arterite de Takayasu (AT) é uma forma rara de doença inflamatória crônica envolvendo grandes vasos, com etiologia incerta, tendo a dor torácica como um sintoma comum e desafiador, consequente à inflamação na raiz ou arco aórtico, artéria pulmonar ou coronárias. O objetivo deste estudo foi relatar a utilização da lidocaína por via endovenosa na abordagem da dor torácica intensa e refratária secundária à AT.
RELATO DO CASO: Paciente do sexo feminino, 33 anos, com diagnóstico de AT, dor torácica intensa de difícil manejo, internada após consulta em serviço de emergência. Dor não responsiva ao tratamento tradicional após uma semana de ajustes em fármacos. Como opção terapêutica, foi escolhido o Bloqueio Simpático Venoso (BSV) com lidocaína, obtendo redução da dor de 10 para 3 na Escala Analógica Visual. Antes da alta hospitalar foi administrado infliximabe. Paciente foi reavaliada em consulta ambulatorial após 30 dias. 
CONCLUSÃO: Esta estratégia fora tratamento da dor torácica intensa permitiu redução e alívio da dor.

Palavras-chave

Anestésicos locais, Arterite de Takayasu, Dor crônica, Dor intratável, Lidocaína, Relato de caso

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Submitted date:
01/18/2023

Accepted date:
10/09/2023

65a6e85ea953957c5072be23 brjp Articles

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