Multifocal and/or non-dermatomal neuropathic pain per Pain Diagram
Failed medical management with at least 2 neuromodulation agents (e.g., gabapentinoids, antidepressants)
Neuropathic component (\>15 points on S-LANSS)
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Non-English speakers
Refusal to sign informed consent
Body weight \> 100 kg
Allergies to ketamine and/or lidocaine
Known contraindications to ketamine use which include poorly controlled systemic illnesses: arterial hypertension, hyperthyroidism, ischemic heart disease, heart failure, psychiatric comorbidity (e.g., history of psychosis, schizophrenia, dissociative state).
Known contraindication to lidocaine use which include current symptomatic or clinically significant brady- or tachyarrhythmia, systolic blood pressure \<90 or \>180 mmHg.
Scheduled interventions targeting neuropathic pain: epidural injections, peripheral nerve blocks, Bier block, radiofrequency of dorsal root ganglia and peripheral nerves, additional lidocaine or ketamine infusions
Newly added analgesic or neuromodulating medications, or recently performed interventions including lidocaine infusions (in the previous 3 months), or previous lidocaine/ketamine infusion in the previous 360 days. -Acute intoxication or active illegal substance abuse (excluding marijuana)
Clareo Health | Lidocaine-Ketamine for Management of Chronic Pain
