Prolonged suppression of tinnitus after peripheral nerve block using bupivacaine and lidocaine

Objective: The local anesthetic lidocaine has been shown to suppress tinnitus, albeit very temporarily, when administered intravenously. Long-term suppression by local anesthetics has not been reported. Bupivacaine has not been studied. Here we report a case of prolonged (1-month) suppression of tinnitus following a peripheral nerve block performed with lidocaine and bupivacaine. Case Report: A 57-year-old man undergoing facet and sacroiliac infiltration with lidocaine and bupivacaine experienced symptoms of systemic local anesthetic toxicity. He described significant perioral numbness. Shortly after this the patient noted that his long-standing and severe tinnitus was completely gone. Follow-up 1 month later revealed the tinnitus had not returned. Longer-term follow-up was not possible because the patient died. Conclusions: There are no reports regarding the use of bupivacaine for suppression of tinnitus. Although previous reports studying lidocaine for this purpose have shown only a brief effect, the use of bupivacaine or a combination of lidocaine and bupivacaine, as in this case, may represent a treatment for tinnitus that is worth further investigation. There currently is no effective long-term therapy for this debilitating problem.