Abstract
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.
Highlights
Herpes zoster is caused by the reactivation of latent varicella-zoster virus
The current study demonstrates that an erector spinae plane (ESP) block provides immediate acute pain relief in patients with severe pain due to herpes zoster infection
Our preliminary experience demonstrated the efficacy of ESP blocks for the management of acute herpetic pain
Summary
Herpes zoster is caused by the reactivation of latent varicella-zoster virus. Acute severe pain and postherpetic neuralgia (PHN) is a feared complication of herpes zoster infection. Treatment of pain in the acute phase of herpes zoster has great importance due to the possible development of PHN. The pain may be severe, persist for months or years, interfere with sleep, and affect the quality of life. Herpes 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
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