Patients with Ehlers-Danlos syndrome experience reduced effectiveness of lidocaine local anesthetic: a randomized cross-over clinical trial
Authors' conclusion
Patients with EDS experienced increased sensation with lidocaine, suggesting shorter duration of effect of lidocaine local anesthetic.
Study context
- Population
- Patients with Ehlers-Danlos syndromes and healthy controls
- Participants
- 135 patients
- Comparison
- Ehlers-Danlos syndromes (EDS) vs healthy controls; anesthetic effect of subcutaneous lidocaine (vs saline) on forearm
- EDSn = 91
- Healthyn = 44reference
- Primary endpoint
- Sensation (standardized 10 g monofilament) after subcutaneous lidocaine, rated relative to non-anesthetized skin, as surrogate of anesthetic effect: delta sensation score and adequate anesthesia (dichotomous)
Methodological detailsinterventional, randomized order of saline and lidocaine injection sites
- Interventional
- Randomized order of saline and lidocaine injection sites
Primary result
As reported in the abstract
Delta sensation score · 15 and 30 min post-injection
| Group | Value | 30 min |
|---|---|---|
| EDS | 1 (range or IQR as printed 0–2) a.u. | 1 (0-2) a.u. |
| Healthy | 2 (range or IQR as printed 1–2) a.u. | 2 (1-2) a.u. |
Value
EDS1 (range or IQR as printed 0–2) a.u.
Healthy2 (range or IQR as printed 1–2) a.u.
30 min
EDS1 (0-2) a.u.
Healthy2 (1-2) a.u.
- EDS vs Healthy: P = 0.002 — 15 min
- EDS vs Healthy: P = 0.003 — 30 min
- Not different at 5 min post-injection between EDS and healthy participants
- P = 0.2
Further findings
Adequate anesthesia (categorical) · 15 min
P = 0.006
Adequate anesthesia (categorical) · 30 min
P = 0.003
- Adequate anesthesia (categorical) — No difference at 5 min between EDS and controls
- p=0.2
Original publication
Patients with Ehlers-Danlos syndrome experience reduced effectiveness of lidocaine local anesthetic: a randomized cross-over clinical trial. Reg Anesth Pain Med. Published 3 March 2026. doi:10.
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