Treatment Of Postherpetic Neuralgia Research Articles

Economic burden of herpes zoster in Latin America: A systematic review and meta-analysis

ABSTRACT This systematic review describes herpes zoster (HZ) economic burden in terms of healthcare resource use and cost outcomes in the Latin America and Caribbean (LAC) region. We searched online databases from 1 January 2000 to 20 February 2020 to identify eligible publications. We identified 23 publications that reported direct costs, indirect costs, and resources associated with HZ and its complications. The primary direct medical resources reported in the different studies were visits to doctors, transportation, days in the hospital, nursing, medication schedules, and physical therapy. Direct total costs per patient ranged from $99.99 to $4177.91. The highest cost was found in Brazil. Direct costs are, in average, 81.39% higher than indirect costs. The cost per patient that includes postherpetic neuralgia treatment is 115% higher on average for the directs and 73% for the indirect costs. Brazil reported a higher total cost per patient than Argentina and Mexico, while for indirect costs per patient, Brazil and Argentina had higher costs than Mexico, respectively. A meta-analysis on the number of days due to HZ hospitalization, performed on non-immunosuppressed patients over 65 years of age from three studies, resulted in a cumulative measure of 4.5 days of hospitalization. In the LAC region, the economic burden of HZ and associated complications is high, particularly among high-risk populations and older age groups. Preventative strategies such as vaccination could help avoid or reduce the HZ-associated disease economic burden in the LAC region.

A Meta-analysis of Randomized Controlled Trials Comparing the Efficacy and Safety of Pregabalin and Gabapentin in the Treatment of Postherpetic Neuralgia.

To systematically evaluate the clinical efficacy of pregabalin and gabapentin in the treatment of postherpetic neuralgia (PHN), including the difference in pain control and occurrence of adverse reactions. PubMed, MEDLINE, EMBASE, Cochrane Library, and Web of Science databases were searched for randomized controlled trials (RCTs) comparing the efficacy of pregabalin and gabapentin in patients with PHN. Data from studies meeting the inclusion criteria were extracted and the Cochrane Risk of Bias risk assessment tool was used to evaluate the quality of the included studies. Revman 5.3 and Stata17 were used to performthe meta-analysis and to detect publication bias. A total of 14 RCTs with 3545 patients were included in this study, including 926 in the pregabalin treatment group, 1256 in the gabapentin treatment group, and 1363 in the placebo control group. Pregabalin was better than gabapentin in alleviating pain and improving the global perception of change in pain and sleep (P < 0.05). Gabapentin was associated with a lower incidence of adverse events than pregabalin (P < 0.05). Funnel plot and Begg's and Egger's tests showed no significant publication bias. Pregabalin appears to have a better overall therapeutic effect than gabapentin for patients with PHN, but gabapentin has a lower incidence of adverse reactions and a better safety profile. Clinicians should comprehensively consider patient factors and fully evaluate the advantages and disadvantages of each treatment option to select the most suitable drugs for patient use. Considering the limited quantity and quality of the existing literature, high-quality RCTs are needed to confirm the advantages of pregabalin over gabapentin in the treatment of PHN and guide clinical decision-making.

A Case Report of Postherpetic Neuralgia Treated with Kyung Hee &lt;italic&gt;Gongjin-dan&lt;/italic&gt; and &lt;italic&gt;Hyangbujapalmul-tang-gagam&lt;/italic&gt;

The most common definition of postherpetic neuralgia is the presence of pain more than a month after the onset of the eruption of zoster. This case report suggests the effect of Korean medicine on postherpetic neuralgia. An 85-year-old male patient with postherpetic neuralgia was treated with a combination of Korean medical remedies. Kyung Hee &lt;i&gt;Gongjin-dan&lt;/i&gt; and &lt;i&gt;Hyangbujapalmul-tang-gagam&lt;/i&gt; were applied for 23 days. The Numerical Rating Scale was used to measure pain intensity. The Barthel Index and Beck Depression Inventory were used for the functional assessment and depression evaluation, respectively. After treatment, the patient’s pain intensity decreased. Additionally, the patient’s independence increased during activity, and the severity of their depression decreased. Thus, this case suggests that a combination of Korean medicine treatments might be effective for postherpetic neuralgia. In particular, it shows that Kyung Hee &lt;i&gt;Gongjin-dan&lt;/i&gt; and &lt;i&gt;Hyangbujapalmul-tang-gagam&lt;/i&gt; can be therapeutic options in the treatment of postherpetic neuralgia.

Comparison of Efficacy of Acupuncture-Related Therapy in the Treatment of Postherpetic Neuralgia: A Network Meta-Analysis of Randomized Controlled Trials.

Background Postherpetic neuralgia (PHN) is the most common sequela of herpes zoster, and the efficacy of the treatment regimens recommended in the guidelines is not entirely reliable. Acupuncture and moxibustion are widely used complementary alternative therapies that have a positive effect on the treatment of PHN. However, there are various forms of acupuncture and moxibustion, and there are differences in efficacy between the different forms. Methods The retrieval work of randomised controlled trials (RCTs) of acupuncture for PHN in English databases (including PubMed, Cochrane Library, Embase, Web of Science) and Chinese databases (including China National Knowledge Infrastructure (CNKI), WeiPu database, WanFang database, and China Biomedical Literature Database) were conducted from the time of database creation to June 2022. Literature screening, data extraction, and evaluation of risk of bias for the included studies were carried out independently by two researchers, and data analysis was performed using Stata 14.2 software. Results A total of 30 RCTs including 2138 patients with PHN were included. In terms of pain improvement, acupoint embedding + Western medicine group, bloodletting-cupping group, and bloodletting-cupping + Western medicine group ranked top. In terms of total efficiency, acupuncture + Western medicine group, bloodletting-cupping + Western medicine group, and acupoint embedding group ranked top. There were no statistically significant differences in the incidence of adverse events between treatment regimens. Conclusions In a comprehensive comparison of the outcome indicators of 14 different treatment regimens, we considered acupoint injection + Western medicine and bloodletting-cupping + Western medicine to be the best combinations for the treatment of PHN. Due to the limitations of the study, the above conclusions still need to be validated in further multi-centre, large-sample prospective randomised controlled clinical trials.

Combined high-voltage pulsed radiofrequency and ozone therapy versus ozone therapy alone in treating postherpetic neuralgia: a retrospective comparison.

Postherpetic neuralgia (PHN) is a devastating disease with extraordinarily poor treatment outcomes. Both pulsed radiofrequency (PRF) and ozone have good effects on the treatment of the disease. However, whether PRF and ozone have a synergistic effect on PHN remains unclear. Therefore, this study aimed to assess the therapeutic effects of ozone alone and in combination with PRF in the treatment of PHN. Ninety-one patients with PHN were assigned into two groups: PRF combined with ozone (PRF + ozone group, n = 44) and ozone therapy alone (ozone group, n = 47). In PRF + ozone group, the high-voltage, long-duration PRF was applied to the target dorsal root ganglions. Then ozonated water (11.5 µg/mL) was injected through the inner cannula. In the ozone group, all other processes were the same as those in the PRF + ozone group apart from the electrical stimulation. The therapeutic efficacy was evaluated by visual analog scale and tactile sensation at pre-treatment and post-treatment 3, 6, and 12 months. Compared with pre-treatment data, the visual analog scale score was significantly decreased in both groups after treatment. Compared with the ozone group, the visual analog scale score was significantly decreased in the PRF + ozone group at 3, 6, and 12 months. Similarly, the tactile sensation was also significantly decreased at post-treatment when compared to pre-treatment. However, there were no statistical differences between the two groups. Regression analysis results showed that the history of diabetes mellitus and age had significant negative and positive effects, respectively, on the treatment results. To conclude, the administration of PRF + ozone and ozone therapy alone could both improve pain symptoms. Moreover, treatment effects and total efficacy rates tended to be higher for the combination of PRF and ozone than ozone alone. This conclusion was especially true for long-term therapeutic effects.

Ultrasound-Guided Dry Needling for Trigger Point Inactivation in the Treatment of Postherpetic Neuralgia Mixed with Myofascial Pain Syndrome: A Prospective and Controlled Clinical Study.

Objective To evaluate the safety and effectiveness of ultrasound-guided dry needling for trigger point inactivation in the treatment of postherpetic neuralgia (PHN) mixed with myofascial pain syndrome (MPS). Methods A prospective and controlled clinical study was conducted. From January 2020 to December 2020, among the 100 patients who received PHN treatment in the pain department, 54 patients complicated with MPS were randomly divided into the dry needling group D (n = 28) and pharmacotherapeutic group P (n = 26). Visual analogue score (VAS) and McGill Pain Questionnaire (MPQ) were taken as primary indicators. Ultrasound-guided inactivation of myofascial trigger points (MTrPs) with dry needling and intradermal needling combined with press needling were applied on group D and pharmacotherapeutic only treatment on group P respectively. The VAS score <3 and/or the MPQ score <2 represents effective treatment. The VAS score >3 and/or the MPQ score >2 represents recurrent in follow-up study three months after the treatment. Results After four weeks treatment, the effective rate of one month later of the group D was 92.9% and the effective rate of group P was 38.5%, respectively. The recurrent rate of group D was 7.1% and 34.6% for group P, respectively, for follow-up three months later. The satisfactory rate of group D was higher than that of group P. Conclusion Ultrasound-guided dry needling and intradermal needling combined with press needling were more effective than only pharmacotherapeutic treatment for PHN mixed with MPS, with lower recurrent rate and higher patient's satisfactory rate.

Comparison of lidocaine and ropivacaine stellate ganglion blockade in treating upper limb postherpetic neuralgia.

To provide a basis for treating postherpetic neuralgia (PHN), we compared the efficacy of lidocaine and ropivacaine stellate ganglion block (SGB) in PHN treatment in the upper limbs.Data from 252 patients with upper-limb PHN were retrospectively analyzed. The lidocaine group (n = 118) was treated with oral pregabalin capsules 75 mg twice a day, tramadol hydrochloride sustained release tablets 100 mg twice a day, and amitriptyline 25 mg once at night combined with ultrasound-guided lidocaine SGB; the ropivacaine group (n = 134) was orally administered the same medicines combined with ultrasound-guided ropivacaine SGB. The visual analog scale (VAS), self-rating anxiety scale (SAS), and adverse reactions were compared between the groups before treatment and at 1 week, 1 month, and 3 months after treatment.There were no significant differences between the lidocaine and ropivacaine groups in terms of sex, age, height, weight, and pain duration (P > .05). There was no significant difference between the groups in VAS and SAS scores before treatment (P > .05). At 1 week, 1 month, and 3 months after ultrasound-guided SGB treatment, the VAS and SAS scores were significantly lower in the ropivacaine group than in the lidocaine group (P < .05). There were no significant differences between the groups in terms of adverse reactions (P > .05).For ultrasound-guided SGB treatment of upper limb PHN, ropivacaine is superior to lidocaine. Ultrasound-guided ropivacaine SGB is safe and effective for the treatment of upper limb PHN.

Pulsed Radiofrequency Combined With Methylene Blue Paravertebral Nerve Block Effectively Treats Thoracic Postherpetic Neuralgia.

ObjectiveTo compare the effect, safety, and patient satisfaction of pulsed radiofrequency combined with methylene blue paravertebral nerve block and pulsed radiofrequency alone in the treatment of thoracic postherpetic neuralgia (PHN).MethodsA total of seventy-two patients with PHN diagnosed in the Department of Pain Management of Shengjing Hospital at China Medical University, from September 2019 to April 2021, were enrolled in the study. Patients were randomly divided into two groups. Group A (n = 36) received pulsed radiofrequency treatment. Group B (n = 36) received pulsed radiofrequency + methylene blue paravertebral nerve block. Patients were followed-up at 1 day, 1 week, 1 month, 3 months, and 6 months after treatment. Observation at each follow-up included basic patient characteristics, Visual Analog Scale (VAS), Hospital Anxiety and Depression Scale (HAD), the Insomnia Severity Index (ISI), patient satisfaction, complications, and side effects.ResultsCompared with preoperative values, the VAS scores significantly decreased in both groups at each postoperative time point (1 day, 1 week, and 1, 3, and 6 months; all p < 0.05). Compared with group A, VAS scores in group B were significantly lower 1 week and 1 month after surgery (p < 0.05). Patients in group B had lower HAD scores than those in group A 1 week after surgery (p < 0.05). Patients in group B had lower ISI scores than those in group A 1 day, 1 week, and 1, 3, and 6 months after surgery (p < 0.05). The pregabalin dosage in group B was lower than that in group A at 1 and 6 months after surgery (p < 0.05). Patient satisfaction was higher in group B than in group A at 1 week and 6 months after surgery (p < 0.05). There were no serious complications or side effects in either group.ConclusionPulsed radiofrequency combined with methylene blue paravertebral nerve block is superior to pulsed radiofrequency alone in the treatment of thoracic PHN, which can significantly relieve PHN and improve the condition of sleep and emotional disorders. Therefore, it is a safe and effective treatment method.

Changing the paradigm in postherpetic neuralgia treatment: lidocaine 700 mg medicated plaster.

Chronic pain is currently considered a disease state with biopsychosocial consequences and a negative impact on patients' quality of life (QoL). Pain from postherpetic neuralgia (PHN) can persist for months or years and is a prototypical example of chronic pain. We analyzed PHN as a model of chronic pain, including its effects on QoL and clinical aspects. We explored treatment options, focusing on the topical treatment with lidocaine 700 mg medicated plaster (LMP) and how this impacts PHN management. This article is a narrative review of published studies. Preclinical and clinical studies were retrieved from literature through a search performed in PubMed/MEDLINE. To choose the appropriate treatment for chronic pains, such as PHN, not only efficacy but also tolerability, manageability, practicality, and compliance are important factors, especially in the long term. It is also important to set treatment expectations with the patients as total suppression of pain may be unrealistic, and a balance needs to be found between pain control and the minimization of adverse events. In this respect, LMP may be the best currently available treatment: it is easy to use, has low systemic absorption and thus a low risk for pharmacological interactions. Therefore, treatments can be personalized, and concomitant medications can be added, if needed. Recent data from a real-world study support this view by showing that LMP has superior effectiveness in reducing pain and improving the QoL compared to other commonly used systemic treatments and confirming its good tolerability profile that is mainly characterized by localized skin reactions. LMP is one of the best currently available treatment options for PHN patients balancing good efficacy with an excellent tolerability profile and can therefore be considered for use as a first-line treatment for PHN.

Herpes zoster-prevention, diagnosis, and treatment

Herpes zoster (HZ) is acommon skin disease resulting from aregionally limited reactivation of alatent infection with the varicella zoster virus (VZV). Despite its usually self-limiting course, HZ is associated with aconsiderable individual and public health burden of disease, particularly due to its high rate of postherpetic neuralgia (PHN). To improve knowledge of the current recommendations for the prevention, diagnosis and treatment. Narrative review and summary of current guideline recommendations. In Germany, the recombinant VZV subunit zoster vaccine is recommended for all adults of 60+ years and for immunocompromised persons of 50+ years. The diagnosis of HZ is clinical; in case of uncertainty, laboratory investigations can help confirm the diagnosis. For patients with HZ ophthalmicus, HZ oticus or neurological complications, an interdisciplinary approach is advantageous. Antiviral treatment should be started as early as possible; various factors, including the duration and location of the disease, the patient's age and signs of acomplicated course, serve to determine the indication to initiate an antiviral medication. The choice of the appropriate treatment depends, among other factors, on the intravenous availability, comorbidities and intake preferences. Early and sufficient analgesic treatment according to the WHO pain ladder and, if required, with anticonvulsant adjuvants is necessary to treat acute pain and to reduce the risk for PHN. Implementation of the current recommendations for the prevention, diagnosis and treatment of HZ and PHN is important to reduce the high burden of disease and improve quality of life of the patients.

대상포진 후 신경통의 중의치료 최신 연구 동향 : CNKI 검색을 중심으로

Postherpetic neuralgia(PHN) is one of the most common intractable chronic pain syndromes. This review was conducted to investigates the trends in recent clinical studies of PHN in China and to find out the efficacy of Chinese medicine treatment for PHN. Based on CNKI databases, nineteen randomized controlled trials(RCTs) were analyzed. The search focused on the authors, publication year, sample size, age, duration of illness, treatment period, lesion sites, methods, outcome measures, and results of the selected articles. Four studies used herbal medicine. The most frequently used herbs were Angelicae Gigantis Radix(當歸) and Corydalis Tube(玄胡索). Eighteen studies used acupuncture treatment. The most frequently used acupoints were ST36, LR3, LI4. Three studies used moxibustion and 5 studies used cupping treatment. In all nineteen studies, the efficacy of Chinese medicine treatments was confirmed. More varied and scientifically designed clinical studies are required to develop treatments for PHN. The results of current study could be used as guidance for further studies of treatment on PHN.

Clinical Effect of Pulsed Radiofrequency in the Treatment of Postherpetic Neuralgia and Its Effect on Quality of Life

Clinical Effect of Pulsed Radiofrequency in the Treatment of Postherpetic Neuralgia and Its Effect on Quality of Life

Efficacy of Electroacupuncture for the Treatment of Postherpetic Neuralgia: Study Protocol for a Multicenter Randomized Controlled Trial

IntroductionPostherpetic neuralgia (PHN) is a severe complication of herpes zoster (HZ), representing an important burden of disease in the elderly. Electroacupuncture (EA) has become growingly appreciated as a therapy of PHN with the situation that effectiveness of conventional therapy of PHN is less than ideal. Owing to its low price, no side effects, high safety and high patients acceptance, EA has been used in treating PHN more frequently. Therefore, the randomized controlled trial which is to evaluate the effectiveness and safety of EA in patients with PHN and whether EA could be an alternative therapy of medication is needed.Patients and MethodsA total of 88 patients with PHN will be recruited from 2 hospitals and randomized assigned to EA group or Medication group in a 1:1 ratio, utilizing a central randomization system. The trial will involve a 4-week treatment period, and a 4-week follow-up period. All variables will be evaluated at week 0 (baseline), week 2 (treatment), week 4 (treatment), week 8 (follow-up) and week 16 (follow-up). Primary outcomes will be pain intensity. Secondary outcomes will contain quality of life, mood state and sleep quality. All adverse effects will be assessed during the trial.ConclusionThis study will provide significant evidence that whether EA therapy is effective and safe for patients with PHN and whether EA could be an alternative therapy of medication.Ethics and DisseminationEthics approval has been obtained from the Ethics Committee of the Hangzhou Third People’s Hospital (No. 2021KAO43). Informed consent will be signed before enrolment. Results of this trial will be presented to international journals for publication and be reported in relevant international conferences.Trial Registration NumberThis protocol has been registered in the Chinese Clinical Trial registry with the identification code ChiCTR2100054592.

Topical Lidocaine Medicated Plaster 5% and Pregabalin for the Treatment of Post-Herpetic Neuralgia: A Systematic Review and Meta-Analysis

Background and objectives: Post-herpetic neuralgia is common severe pain that leads to poor quality of life. Various topical and systemic drugs were in use including topical lidocaine medicated plaster 5% (05% LMP. This is the first meta-analysis to compare 5% lidocaine medicated plaster and pregabalin. Thus, this study aimed to assess the effectiveness of 5% LMP and pregabalin in PHN and compare these medications regarding the same.&#x0D; Methods: We searched PubMed, MEDLINE, Google Scholar, EBSCO, and Cochrane Library for publications assessing 5% lidocaine medicated plaster and pregabalin drugs on post-herpetic neuralgia. We included articles published in English from inception up to February 2022. All types of studies were included except case reports, case series, studies on animals, and experimental studies. The terms used were: 5% lidocaine medicated plaster, pregabalin, post-herpetic neuralgia, pain relief, pain reduction, and pain scores. We identified 579 articles and the number stood at 435 after duplication removal, of them, 45 full texts were screened. Eight cohorts from seven studies were included in the final meta-analysis. The most recent RevMan system was used for data analysis.&#x0D; Results: The pain score was significantly lower among patients receiving topical lidocaine compared to placebo or pre and post-intervention (odd ratio, -1.91, 95% CI, -3.77-0.04). Lidocaine Medicated Plaster 5% and pregabalin were effective for pain relief in PHN. However, 5% LMP was more effective (odd ratio, 2.11, 95% CI, 1.41-3.17).&#x0D; Interpretation and Conclusion: Five % lidocaine medicated plaster was effective for the treatment of post-herpetic neuralgia. In addition, the drug was more beneficial than placebo and pregabalin. Further randomized controlled studies assessing the use of LMP 5% on acute herpes zoster and post-herpetic neuralgia are recommended.

Neurolytic erector spinae plane block a treatment for postherpetic neuralgia a case Report

Neurolytic erector spinae plane block a treatment for postherpetic neuralgia a case Report

Efficacy of Vitamin C Combined with Famciclovir in the Treatment of Post-Herpetic Neuralgia

The present randomized controlled, double blinded interventional clinical study aimed to investigate the efficacy of vitamin C combined with famciclovir in post-herpetic neuralgia. The patients in the control group (n = 43) were intravenously given with famciclovir (0.25 g/day) while patients in the observation group (n = 43) were intravenously given with vitamin C combined with famciclovir. The clinical observation indexes, changes of pain score, immune cytokines, and complications were compared between the two groups. Compared with the control group, the observation group had higher total effective rate, shorter blister-stopping time, crusting time, and pain-relieving time. After treatment for 14 days, the visual analogue scale score in the observation group was 0.54 ± 0.17, which was lower than the control group (2.72 ± 0.43). After treatment, serum interleukin-6 and interleukin-8 levels were significantly lower in the observation group than the control group. There was no significant difference in the incidence of adverse reactions between the two groups. However, the number of rescue medication in the observation group was lower than the control group. To sum up, famciclovir combined with vitamin C in the treatment of post-herpetic neuralgia can improve the cured rate of the disease, which is worthy of clinical application.

Treatment Analysis of Patients Followed up With Postherpetic Neuralgia in Nothern Cyprus.

Background:Postherpetic neuralgia (PHN) is a frequent complication of herpes zoster (HZ). Treatment of this chronic pain syndrome and results are often not clear. Tricyclic antidepressants, gabapentinoids and potent opioids are first-line treatments and are highly effective, but their use is limited due to adverse effects that may occur in elderly patients with significant medical comorbidities or interaction due to multiple drug use. There are no head-to-head comparisons of non medical treatments. Dry needling appears comparable to conventional physical therapy for treating PHN.Objective:Our aim is to determine the incidence of PHN in our population and to compare the treatments in patients with postherpetic neuralgia.Methods:A search for HZ and PHN was conducted in a general practice research database, comprising 2 general practices (dermatologist and physiatrist) and representing 5600 people. We analyzed a retrospective 37 case with PNH of 170 herpes zoster patient admmited to the dermatology and physical therapy and rehabilitation outpatient clinic between October 2018 and October 2020. Dry needling and physical therapy methods applied in addition to medical treatment in PHN treatment were compared.Results:In patients with postherpetic neuralgia, both dry needling therapy group and physical therapy group LANSS scores decreased significantly in the first week and in the third week compared to baseline. Dry needling therapy group has also similar results in VAS scores in the first and third week. But in physical therapy group, the VAS score did not show a significant decrease in the first week compared to the baseline, but it decreased significantly in the third week.Conclusion:PHN is a complex, difficult to treat and severe neuropathic pain that affects patients’ daily function and quality of life. Various agents and methods are available to relieve the symptoms of PHN. This study shows as both physical therapy and dry needling therapy are effective treatment for postherpetic nevralgia..

Meta-Analysis of the Clinical Effect of Acupuncture on Postherpetic Neuralgia

Objective: To systematically evaluate the safety and efficacy of acupuncture on patients with postherpetic neuralgia?Methods: Based on the heyword retrieval method, China National Knowledge Infrastructure (CNKI, 1978-2020), China Biomedical Literature database (CBM, 1979-2020), VIP database (WEIPU, 1989-2020), Wanfang database (1989-2020), Cochrane Library, PubMed, and Embase were searched; randomized controlled trials of the use of acupuncture in the treatment of postherpetic neuralgia were screened out; the quality of the included literatures was evaluated based on the evaluation criteria in the Cochrane Handbook, and meta-analysis was performed using RevMan 5.3. Results: Twenty-six literatures that met the criteria, involving 2,174 patients, were included; the meta-analysis showed that compared with western medicine, the use of acupuncture can improve the overall effective rate (RR = 1.24, 95% CI [1.17, 1.32], P &lt; 0.00001) and reduce the VAS score (MD = -1.43, 95% CI [-1.97, -0.89], P &lt; 0.00001). Conclusion: The use of acupuncture can further improve the clinical effect of patients with postherpetic neuralgia.

Analysis of the Effect of TCM Nursing in the Treatment of Postherpetic Neuralgia by Acupuncture and Moxibustion

Analysis of the Effect of TCM Nursing in the Treatment of Postherpetic Neuralgia by Acupuncture and Moxibustion

Ultrasound-Guided Stellate Ganglion Block Combined with Extracorporeal Shock Wave Therapy on Postherpetic Neuralgia.

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.