Abstract
Objectives To evaluate the effect of ultrasound-guided stellate ganglion block combined with extracorporeal shock wave therapy (ESWT) on postherpetic neuralgia. Methods Thirty-six patients with craniofacial postherpetic neuralgia, whose skin lesions were healed and natural course more than 1 month, were selected for the study and then randomly divided into 3 groups: the ultrasound-guided stellate ganglion block group (group A, n = 12), the extracorporeal shock wave therapy group (group B, n = 12), and the combined treatment group (group C, n = 12). Each group received basic drug treatment. The Visual Analogue Scale (VAS) and the Pain Disability Index (PDI) were used to evaluate the clinical effects of the 3 groups of patients before treatment, after twice treatments, after treatment for four times, and after treatment for six times. Results The VAS and PDI were significantly declined in each group after the treatment (P < 0.05), and the declination in group C was more obvious than the other two groups (P < 0.05). After treatment for six times, the VAS score of group A, group B, and group C was 3.1 ± 1.2, 3.3 ± 1.3, and 1.9 ± 0.7, respectively. After treatment for six times, the PDI of group A, group B, and group C was 11.7 ± 8.4, 12.3 ± 7.8, and 4.6 ± 3.2, respectively. Three patients developed skin bruising and slight swelling, which were relieved by themselves. Conclusions Ultrasound-guided stellate ganglion block combined with shock wave therapy could significantly improve the pain symptoms of patients with postherpetic neuralgia, which is a safe and effective treatment for postherpetic neuralgia.
Highlights
Postherpetic neuralgia (PHN) is a common clinical neuropathic pain
The total incidence of neuralgia after acute herpes virus infection is 9–34%, and the incidence is as high as 65–73% in patients over 60 years old [2]. e pain is severe and is a refractory disease, mostly manifested as spontaneous pain, hyperalgesia, abnormal pain, and paresthesia, causing patients to sleep and eat, emotional restlessness, and seriously affecting the quality of life and normal work. erefore, timely and effective control of pain and improvement of patients’ quality of life have become the focus of rehabilitation of patients with postherpetic neuralgia
Drug treatment, nerve block, and radiofrequency therapy are often recommended in the treatment guidelines for PHN, but only 40–50% of patients have achieved satisfactory efficacy [3]. e mechanism of stellate ganglion block (SGB) in the treatment of pain is to improve the blood supply of the head and neck, inhibit the overexcitement of sympathetic nerves, regulate endocrine system, and relieve pain; at the same time, it can reduce the patients’ fear, anxiety, and other symptoms and improve immune function, and enhance anti-inflammatory effect [4]
Summary
Postherpetic neuralgia (PHN) is a common clinical neuropathic pain. Erefore, timely and effective control of pain and improvement of patients’ quality of life have become the focus of rehabilitation of patients with postherpetic neuralgia. Extracorporeal shock wave therapy (ESWT) can generate tensile and compressive stresses through shock waves, causing piezoelectric effects and cavitation effects, changing the cell potential of local lesions, generating charge change, and exerting biological effects. It produces physical effects in the soft tissues to release adhesions and relieve pain [5]
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