Treatment information
Understanding your pathway
What is the treatment?
An infusion delivers medicine into a vein in a monitored setting. In pain medicine, different medicines may be discussed for selected presentations, and each has a different evidence base and risk profile. Infusion therapy is therefore not one standard treatment with a single indication, schedule or expected result. [1][2]
Who may be considered?
Suitability depends on the proposed medicine, diagnosis, previous treatment and medical history. Heart, liver, kidney and mental health conditions, pregnancy and interacting medicines may affect the decision. The clinician should identify the exact medicine and purpose rather than offer an infusion based only on a general chronic-pain label. [1][2]
Assessment, preparation and consent
Before deciding, discuss your diagnosis, previous treatment, medicines and relevant health conditions. Tell the clinician about allergies, infection, blood-thinning medicines, diabetes and possible pregnancy. Do not stop prescribed medicines yourself. Ask what alternatives are available, including not having a procedure, and allow time to consider the benefits, uncertainty and risks that matter to you. [3]
What happens during treatment?
A cannula is placed in a vein and medication is delivered at a controlled rate. Observations and, for some medicines, heart-rhythm monitoring are used. The treatment team explains what sensations to report and when an infusion would be reduced or stopped. Preparation and duration follow the specific medicine and local protocol. [1][2]
Risks and safety considerations
Adverse effects differ by medicine. Lidocaine can affect heart rhythm and cause neurological toxicity. Ketamine can cause altered perception, nausea, sedation and cardiovascular changes. Cannula problems and allergic reactions are also possible. Ask about risks relevant to the proposed medicine, including those associated with repeated exposure. [1][2]
Recovery and when to seek help
Follow the written instructions for transport, supervision, medicines, activity and driving. Recovery depends on the treatment and your health, so a fixed return-to-work date cannot be promised. Ask who to contact outside clinic hours. Seek urgent assessment for fever with worsening pain, new weakness or other unexpected neurological symptoms. Call 000 for breathing difficulty, collapse or another medical emergency. [4][3]
Expected benefit and limitations
Benefit may be absent or temporary. A response to one medicine cannot establish the effectiveness of another or justify indefinite maintenance infusions. Agree functional goals and a stopping or review plan before treatment. Transport, supervision and driving instructions should be provided; feeling better immediately afterwards is not clearance to drive. [1][2]
Follow-up and rehabilitation
Before treatment, choose a practical goal such as walking, sleep or a daily task. Record changes in that activity, pain and any adverse effects, then discuss them at follow-up. Ask what degree of change would justify further treatment and what would lead to stopping or changing the plan. Rehabilitation and self-management may remain part of care even if symptoms improve. [3][5]
Questions to bring to your appointment
Ask which structure is being targeted, why this approach is being considered and how strong the evidence is for your diagnosis. Clarify costs, the planned review date and any practical help you may need at home. Bring previous reports and your medicine list so the discussion can address your circumstances rather than a generic treatment pathway.
Sources and further reading
Sources support the statements cited above. Overseas guidance may describe different services or eligibility rules. A procedure leaflet explains a technique and its risks; it does not establish that the treatment is effective for every condition.
- Lidocaine infusions — The Dudley Group NHS Foundation Trust
- Intravenous ketamine infusion nursing care clinical guideline — Royal Cornwall Hospitals NHS Trust
- Procedures in pain medicine clinical care standard — Faculty of Pain Medicine, ANZCA
- Dorsal root ganglion / nerve root block / transforaminal injection — Hull University Teaching Hospitals NHS Trust
- Options for chronic pain management — Healthdirect Australia