Overview
Chronic pelvic pain can involve nerve sensitisation, where pain pathways remain overactive even when the original trigger has improved. This can lead to persistent burning, stabbing, or radiating pain and may be associated with central sensitisation, sleep disruption, fatigue, and reduced tolerance for daily activity.
IV lidocaine and ketamine infusions aim to calm overactive nerve pathways and reduce pain amplification. They are delivered in a monitored clinical setting and are usually considered when pain is strongly nerve related, widespread, or persistent despite medication optimisation, physiotherapy, and targeted injections.
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 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 these treatments are not appropriate for everyone.
What Is an IV Lidocaine and Ketamine Infusion
IV Lidocaine infusion uses lidocaine delivered slowly through a drip. 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 via a small cannula into a vein
• Given in a controlled, monitored 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 suitability, current medications, and medical history. During the infusion:
• Monitoring is applied for heart rate, blood pressure, and oxygen levels
• A cannula is placed in the arm or hand
• Medication is delivered slowly over a set period
• You remain under supervision throughout
• You are observed after the infusion before discharge
Infusion duration varies depending on protocol and clinical need.
After the Procedure
You may feel tired, lightheaded, or temporarily drowsy. Some people experience gradual improvement over hours to days. In some cases, a series of infusions is recommended depending on response.
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 changes
• 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 care and rehabilitation
Possible Risks and Side Effects
Potential side effects vary by medication and 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 rare
Your consultant will explain expected effects and ensure monitoring throughout treatment.
When to Consider Other Options
Infusion therapy may not be suitable if pain is not nerve related, if certain heart or liver conditions are present, or if medication interactions create risk. Other options may include targeted nerve blocks, epidural injections, pelvic floor therapy, psychological support for pain processing, or a multidisciplinary pain programme.
Safety Note
Please inform your consultant about all medications, allergies, and medical conditions. 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 your pelvic pain.