Effect of Single Intra-cutaneous Injection for Acute Thoracic Herpes Zoster and Incidence of Postherpetic Neuralgia

Cui, Jizheng; Zhang, Jinwei; Yan, Fang; Yang, Xiaona; Wang, Xinling; Zhao, Zhibin; Zhang, Xiao-bao; Geng, Zhu-sheng

doi:10.1016/j.pmn.2017.09.002

Cited by 16 publications

(31 citation statements)

References 24 publications

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“…Even with adequate medical treatment using antiepileptics, analgesics, and antivirals, some patients do not have sufficient pain relief and may need additional interventional procedures. Various nerve blocks are found to provide effective analgesia and prevent progression to post-herpetic neuralgia by decreasing the painful stimuli and alleviating central sensitization during the acute phase of herpes zoster infection [3].…”

Section: Discussionmentioning

confidence: 99%

“…Acute severe pain and post-herpetic neuralgia (PHN) is a feared complication of herpes zoster infection. The reported incidence of PHN varies between 5% and 50% depending on the study design, age distribution, and definition [1-3]. Treatment of pain in the acute phase of herpes zoster has great importance due to the possible development of PHN.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound-guided Erector Spinae Plane Block for the Management of Herpes Zoster Pain: Observational Study

Aydın

Balaban

Ahişkalıoğlu

et al. 2019

Cureus

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BackgroundHerpes zoster is caused by the reactivation of latent varicella-zoster virus, which promotes acute and chronic pain that may interfere with daily activities and reduce the quality of life. Ultrasound-guided erector spinae plane (ESP) blocks are used for a wide variety of indications in the management of acute, chronic, and postoperative pain. Our aim was to evaluate the efficacy of ultrasound-guided erector spinae plane blocks for the management of pain in herpes zoster.MethodsThe medical records of 34 patients with acute or chronic pain during herpes zoster between May 2017 and June 2018 were investigated at two pain clinic centers. The patients received ultrasound-guided erector spinae plane block: We performed a single injection for the patients having acute pain and a continuous block for the patients having chronic pain. Patient characteristics, block characteristics (needle insertion level, catheter, or single insertion), the volume of given local anesthetics, the intensity of pain before and after the block procedure using a numerical rating score (NRS) between 0 and 10, and the duration of analgesia were evaluated.ResultsAll patients reported a remarkable and rapid resolution of pain immediately after the block procedure. Median (min-max) NRS score before the block procedure was 9 (4-10). The median (min-max) NRS score was 1.5 (0-7) after the block procedure. The difference was found to be statistically significant (p<0.0001). NRS score after the third month was 1 (0-3); the difference is statistically significant (p=0.002). The median value of analgesia time (min-max) was 18 (3-24) hours.ConclusionOur preliminary experience demonstrated that an ESP block provided sufficient analgesia in acute herpetic pain. A combination of ESP block, pregabalin, and tramadol was also effective within the three-months-period after the block performance.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided Erector Spinae Plane Block for the Management of Herpes Zoster Pain: Observational Study

Aydın

Balaban

Ahişkalıoğlu

et al. 2019

Cureus

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“…In the literature, the pain NRS scores decreased significantly in all patients with post-zoster neuralgia one month after rash onset. Still, patients who received standard treatment plus subcutaneous injection showed substantially more significant improvement in pain scores than those who received standard therapy alone 5,6) . As hyaluronic acid is highly hydrophilic, it is a polymer that is well suited to applications requiring minimal cellular adhesion.…”

Section: Discussionmentioning

confidence: 96%

“…Since then, there have been a few similar reports. Nerve block, in combination with corticosteroids, is now widely used in the treatment of post-zoster neuralgia 5,6,8) . The first use of intralesional corticosteroid injections would seem to be a reasonable therapeutic measure in herpes zoster since probably neural and perineural inflammation are essential in the development of symptoms.…”

Section: Discussionmentioning

confidence: 99%

Effect of the Combination Treatment of Injection to Scar and Intercostal Nerve Block for Patients with Post-Zoster Neuralgia on the Trunk

et al. 2019

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Objective: The purpose of this study was to investigate the effect of the combination treatment of injection to scar and ICNB for patients with post-zoster neuralgia on the trunk. Methods: We collect retrospective data on 23 patients undergoing combination treatment of injection to scar and ICNB in the management of neuropathic pain in patients with post-zoster neuralgia on the trunk during eight years beginning on January 1, 2011. We performed a combination treatment of injection to scar and intercostal nerve under fluoroscopy. The mixture of 3 mL of 0.5% bupivacaine containing 1 mg of triamcinolone and hyaluronic acid was injected around the scar and intercostal nerve under fluoroscopy. Pain intensity was measured using a visual analog score (VAS), quality of life scale (QOLS) and morphine consumption were measured at baseline and after management. Results: The mean (±SD) VAS of baseline status was 7.3 (±0.56) before the combination treatment in the management of episodic pain with constant pain in patients with post-zoster neuralgia. VAS decreased to 2.26±1.05 after the combination treatment compared with baseline VAS and was sustained by 2.35±0.83 for 1 week and by 2.48±0.99 at 1 month. After 6 months, the pain remained at 2.52±1.16. In morphine consumption, the baseline doses were 104±126 mg/day that significantly reduced to 40±20 mg/day and 32±17 mg/day after one 1-month and 6-months postprocedure (p<0.001). The dose of gabapentin (1,200±300 mg/day) before treatment. The dose of gabapentin in the first month did not significantly decrease in taking gabapentin (1,000±300 mg/day) compared with the baseline dose (1,200±300 mg/day). Consumption after 6 months was also significantly reduced by 600±300 mg/day. Conclusion: This clinical study suggests that the combination treatment of injection to scar and intercostal nerve block for patients with post-zoster neuralgia on the trunk is effective and safe for relieving post-zoster neuralgia

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“…Neuropathy is a painful condition resulting from the damage to the nerves, and patients taking chemotherapeutic and antiviral drug therapy are more likely to suffer from neuropathic pain . Other pain conditions that are associated with nerve damage include fibromyalgia, spinal cord injury, multiple sclerosis, and stroke .…”

Section: Introductionmentioning

confidence: 99%

Pain attenuating actions of vincristinet‐preconditioning in chemotherapeutic agent‐induced neuropathic pain: key involvement of T‐type calcium channels

Sharma

Маслов

Singh

et al. 2019

Fundamemntal Clinical Pharma

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Preconditioning is a well-documented strategy that induces hepatic protection, renal protection, cardioprotection, and neuroprotection but its mechanism still remains to be elucidated. Hence, the present study investigated the protective mechanism underlying pain attenuating effects of vincristine-preconditioning in chemotherapeutic agent-induced neuropathic pain. Neuropathic pain was induced by administration of vincristine (50 µg/kg, i.p.) for 10 days in rats. Vincristine-preconditioning was induced by administration of vincristine (2, 5, and 10 µg/kg, i.p) for 5 days before administration of pain-inducing dose of vincristine (50 µg/kg, i.p.). Vincristine-preconditioning (10 µg/kg, i.p) for 5 days significantly reduced vincristine (50 µg/kg, i.p.) induced pain-related behaviors including paw cold allodynia, mechanical hyperalgesia, and heat hyperalgesia. However, vincristine (2 and 5 µg/kg, i.p) did not significantly ameliorate the vincristine (50 µg/kg, i.p.) induced neuropathic pain in rats. Furthermore, to explore the involvement of calcium channels in pain attenuating mechanism of vincristine-preconditioning, Ttype calcium channel blocker, ethosuximide (100 and 200 mg/kg, i.p.) and L-type calcium channel blocker, amlodipine (5 and 10 mg/kg, i.p.) were used. Pretreatment with T-type calcium channel blocker, ethosuximide significantly abolished vincristine-preconditioning-induced protective effect. However, pretreatment with L-type calcium channel blocker, amlodipine did not alter vincristine-preconditioning-induced pain-related behaviors. This indicates that vincristine-preconditioning has protective effect on pain-related parameters due to opening of calcium channels, particularly T-type calcium channels that lead to entry of small magnitude of intracellular calcium through these channels and prevent the deleterious effects of high-dose vincristine.

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Effect of Single Intra-cutaneous Injection for Acute Thoracic Herpes Zoster and Incidence of Postherpetic Neuralgia

Cited by 16 publications

References 24 publications

Ultrasound-guided Erector Spinae Plane Block for the Management of Herpes Zoster Pain: Observational Study

Ultrasound-guided Erector Spinae Plane Block for the Management of Herpes Zoster Pain: Observational Study

Effect of the Combination Treatment of Injection to Scar and Intercostal Nerve Block for Patients with Post-Zoster Neuralgia on the Trunk

Pain attenuating actions of vincristinet‐preconditioning in chemotherapeutic agent‐induced neuropathic pain: key involvement of T‐type calcium channels

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