Overview
IV lidocaine and ketamine infusion is an advanced treatment used when chronic pelvic pain involves nerve sensitisation or persistent pain signalling within the nervous system. In some patients, pelvic pain continues even after the original injury or trigger has improved because the nervous system remains overactive.
This can lead to symptoms such as burning, stabbing, or radiating pelvic pain and may also be associated with central sensitisation, sleep disruption, fatigue, and reduced tolerance for daily activity.
IV lidocaine and ketamine infusions aim to calm these overactive nerve pathways and reduce pain amplification. They are delivered in a monitored clinical setting and are typically considered when pelvic pain is strongly nerve related, widespread, or persistent despite medication optimisation, physiotherapy, and targeted injection treatments.
Who this treatment helps
IV lidocaine or ketamine infusion may be suitable for people with:
- Chronic pelvic pain with nerve related features
- Pudendal neuralgia or other pelvic nerve pain conditions
- Widespread nerve pain patterns affecting daily function
- Pain following surgery, trauma, or nerve injury
- Central sensitisation with increased pain sensitivity
- Limited improvement with conventional treatments
A consultation is required to confirm suitability, as infusion therapy is not appropriate for everyone.
What is an IV lidocaine and ketamine infusion
IV lidocaine and ketamine infusion therapy involves medication delivered slowly through a drip into a vein.
IV lidocaine infusion uses lidocaine administered through a controlled intravenous infusion. Lidocaine can reduce nerve sensitivity and dampen pain signalling by acting on nerve channels involved in pain transmission.
IV ketamine infusion uses low dose ketamine delivered through a drip. Ketamine acts on receptors involved in pain amplification and sensitisation and may help reduce persistent neuropathic pain in selected cases.
Both treatments are:
- Delivered through a small cannula placed in a vein
- Administered in a monitored clinical environment
- Supervised by a consultant and trained clinical team
- Used as part of a broader pain management plan rather than as a standalone cure
What to expect during the procedure
Your consultant will review your medical history, medications, and suitability before treatment begins.
During the infusion:
- Monitoring is applied for heart rate, blood pressure, and oxygen levels
- A cannula is placed in the arm or hand
- The medication is delivered slowly over a controlled period
- You remain under supervision throughout the infusion
- You are observed for a short time after the infusion before discharge
The duration of the infusion varies depending on the protocol used and your individual clinical needs.
After the procedure
After IV lidocaine or ketamine infusion you may feel tired, lightheaded, or temporarily drowsy. Some people notice gradual improvement over hours to days.
In some cases a series of infusions may be recommended depending on response to treatment.
Your consultant may advise:
- Avoid driving for 24 hours
- Rest for the remainder of the day
- Continue physiotherapy or rehabilitation as planned
- Keep a symptom diary to track improvement
- Report any concerns promptly
Benefits
- May reduce chronic pelvic or nerve related pain
- Can calm pain amplification pathways
- Performed as a monitored day case treatment
- May improve sleep, mobility, and daily function
- Useful when other treatments have been ineffective
- Can complement multidisciplinary pain management
Possible risks and side effects
Side effects vary depending on the medication used but may include:
- Lightheadedness or dizziness
- Nausea
- Temporary changes in sensation
- Temporary dissociation or vivid sensations with ketamine
- Changes in blood pressure or heart rate
- Allergic reaction, which is rare
Your consultant will explain the expected effects and monitor you carefully throughout treatment.
When to consider other options
If infusion therapy is not suitable or if symptoms suggest other pain pathways, your consultant may discuss pudendal nerve block, ganglion impar block, hypogastric plexus block, targeted injection treatments, pelvic floor therapy, or multidisciplinary pain management.
Safety note
Please inform your consultant about all medications, allergies, and medical conditions before treatment. Certain heart, liver, or medication interactions may affect suitability. You will usually need someone to accompany you home after the infusion.
Arrange a consultation to discuss whether IV lidocaine or ketamine infusion therapy may be suitable for managing your pelvic pain.
You can also explore our pelvic pain treatments, view related treatments such as pudendal nerve block or ganglion impar block, or browse all pain treatments.