IV lidocaine for headaches after non‑traumatic subarachnoid hemorrhage

Lidocaine Infusion As A Treatment Modality For Headache Following Non-Traumatic Subarachnoid Hemorrhage: A Prospective, Single-Center, Observational Cohort Study

This project will try an IV lidocaine infusion to see if it reduces moderate to severe headaches in adults who had a non‑traumatic subarachnoid hemorrhage.

Quick facts

• Study type: Observational
• Enrollment: 20 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: University of Kansas Medical Center (Academic / other)
• Locations: 1 site (Wichita, Kansas)
• Trial ID: NCT06582810 on ClinicalTrials.gov

What this trial studies

This prospective observational project will give adults with non‑traumatic subarachnoid hemorrhage an intravenous lidocaine infusion as part of their headache treatment while collecting data on pain and safety. Patients will report numeric pain scores every two hours while awake for up to seven days, and clinicians will monitor for vasospasm as part of routine care. Inclusion requires age over 18, a Hunt and Hess score of 3 or less, and the ability to communicate pain scores; significant cardiac disease, arrhythmia, seizures, or prior lidocaine allergy exclude participants. The design is non-randomized and descriptive, so results will show safety and pain trends rather than prove definitive causation.

Who should consider this trial

Good fit: Ideal candidates are adults with non‑traumatic subarachnoid hemorrhage who are neurologically stable (Hunt and Hess ≤3), can give numeric pain scores, and have no contraindications to lidocaine.

Not a fit: Patients with traumatic subarachnoid hemorrhage, severe neurologic impairment (Hunt and Hess >3), chronic preexisting pain, prior aneurysm, or contraindications to lidocaine are unlikely to benefit from this intervention.

Why it matters

Potential benefit: If successful, IV lidocaine could provide a relatively fast and well-tolerated way to reduce severe post‑SAH headaches and improve patient comfort during recovery.

How similar studies have performed: Applying IV lidocaine to post‑SAH headache is relatively novel—small case reports and limited trials of IV lidocaine for refractory headache suggest possible benefit, but strong evidence in subarachnoid hemorrhage is lacking.

Eligibility criteria

Inclusion Criteria:

* Patients \> 18 years;
* Have a favorable neurological status defined as Hunt and Hess score ≤ 3 (as it accounts for patient awareness);
* Can communicate numeric pain scores;
* Are diagnosed with non-traumatic subarachnoid hemorrhage

Exclusion Criteria:

* The patient is diagnosed with traumatic subarachnoid hemorrhage;
* If the patient is \< 18 years of age;
* If numeric pain scores could not be captured for \> 3 days of hospitalization;
* If the patient had a prior aneurysm;
* Chronic pain not associated with non-traumatic subarachnoid hemorrhage diagnosis;
* A disability before the stroke (\> 2 on modified Rankin Scale score);
* A Hunt and Hess score \> 3;
* Contraindications to lidocaine (significant cardiac disease, arrhythmia, seizures, previous allergic reaction to lidocaine

Where this trial is running

Wichita, Kansas

• Ascension Via Christi St. Francis — Wichita, Kansas, United States (Recruiting)

Study contacts

• Principal investigator: Fernando Salgado, MD — University of Kansas Medical Center
• Study coordinator: William L Krogman, MS

Conditions Subarachnoid; Hemorrhage, Nontraumatic; Headache; Nontraumatic Subarachnoid Hemorrhage; Lidocaine Infusion