Abstract
Epidural, intrathecal, and sympathetic blocks are used for the treatment of pain caused by herpes zoster (HZ) and postherpetic neuralgia (PHN). This study was undertaken to evaluate and synthesize existing evidence for using these nerve blocks with various injectates (local anesthetic [LA] alone, LA + steroids) in treating pain of HZ, PHN (>6 months), and its prevention. A computerized search of published trials in the English language from 1966 to 2001 was carried out on Medline, EMBASE, and Cochrane Clinical Trial databases. Levels of evidence and grades of recommendations were made based on criteria published by the Oxford Centre for Evidence-Based Medicine. Among the studies meeting inclusion criteria, treatment was initiated during acute pain in 71% (15/21) and PHN in 29% (6/21). Randomized controlled trials (RCTs, level 1b evidence) constituted 19% (4/21), individual cohort (levels 2b, 3b) 29% (6/21), and case series (level 4) 43% (9/21). Overall, 80% (15/21) of trials showed a positive outcome with these blocks. The use of sympathetic (LA) and epidural blocks (LA + steroid) for pain of HZ was supported by 1 RCT each, and intrathecal block (LA + steroid) for PHN was supported by 2 RCTs. Evidence for the beneficial effect ...Continue Reading
References
May 1, 1978·Canadian Anaesthetists' Society Journal·J B Forrest
Aug 1, 1991·Acta Neurologica Scandinavica·T NurmikkoD Bowsher
Dec 1, 1990·The Clinical Journal of Pain·T J NurmikkoV Häkkinen
May 1, 1987·Pain·R TestaG A Abbiati
Dec 1, 1986·Annals of Neurology·R K PortenoyK M Foley
Jan 1, 1987·Anesthesiology·H YanagidaG Corssen
Dec 1, 1985·Pain·N S Milligan, T P Nash
Jan 1, 1980·Canadian Anaesthetists' Society Journal·J B Forrest
Jun 1, 1984·Archives of Dermatology·J M RiopelleK P Grush
Oct 1, 1995·Chest·D J CookR J Goldberg
Jan 1, 1995·Journal of Clinical Epidemiology·R E Slavin
Feb 18, 1995·BMJ : British Medical Journal·R J Cook, D L Sackett
Jan 15, 1994·Annals of Internal Medicine·M E JohnstonA Mathieu
Sep 1, 1995·The Clinical Journal of Pain·H ManabeK Higa
Feb 1, 1996·Family Practice·J VolminkC Silagy
Jul 1, 1996·Anaesthesia·J W WattD R Bowsher
Aug 1, 1997·Annals of Internal Medicine·D J CookS R Weingarten
Feb 7, 1998·Pain·W S Kingery
Apr 29, 1998·Regional Anesthesia and Pain Medicine·K HigaK Dan
Aug 13, 1999·Regional Anesthesia and Pain Medicine·S E Abram
Aug 13, 1999·Regional Anesthesia and Pain Medicine·A KikuchiA Matsuki
Nov 24, 1999·Archives of Dermatology·S M HwangE H Choi
Aug 5, 2000·Pain·C L WuR H Dworkin
Sep 12, 2000·Acta Anaesthesiologica Scandinavica·R W Johnson
Sep 12, 2000·Acta Anaesthesiologica Scandinavica·A PasqualucciF Del Sindaco
Nov 23, 2000·The New England Journal of Medicine·N KotaniA Matsuki
Apr 11, 2001·Spine·C Manniche, A Jordan
Sep 19, 2001·Regional Anesthesia and Pain Medicine·D B Carr, L C Goudas
Citations
Dec 5, 2006·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Robert H DworkinRichard J Whitley
Feb 27, 2013·Age and Ageing·Aza AbdullaUNKNOWN British Geriatric Society
Nov 19, 2009·Regional Anesthesia and Pain Medicine·Honorio T BenzonKhalid Malik
Aug 3, 2012·Regional Anesthesia and Pain Medicine·Ottokar Stundner, Stavros G Memtsoudis
Aug 24, 2012·Current Opinion in Anaesthesiology·Olivia Finnerty, John G McDonnell
Aug 21, 2009·International Journal of Clinical Practice·R W Johnson, J McElhaney
Jan 24, 2006·Anesthesia and Analgesia·Mayumi TakatoriMunetaka Hirose
Aug 29, 2009·Anesthesia and Analgesia·Genlin JiLize Xiong
Jul 23, 2011·Anesthesia and Analgesia·Hyung Seok YooChul Joong Lee
May 17, 2011·Journal of the American Geriatrics Society·Robert H DworkinSissi V Pham
Aug 6, 2016·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Ji-Zheng CuiJi-Ying Feng
Jan 12, 2019·BMJ : British Medical Journal·Phuc Le, Michael Rothberg
Jul 2, 2019·The Korean Journal of Pain·A Ram DooJi-Seon Son
Oct 3, 2019·Medicine·Chung Hun LeeJong Sun Park
Oct 12, 2013·Postgraduate Medicine·Mazen S Bader
Jan 30, 2020·BMC Anesthesiology·Chung Hun LeeJong Sun Park
Jul 7, 2020·Pain Practice : the Official Journal of World Institute of Pain·Diab Fuad HettaMontaser A Fattah Mohammad
Oct 3, 2006·Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG·Sawko W Wassilew
Nov 22, 2011·European Journal of Pain Supplements·Kai McGreevySrinivasa N Raja
May 20, 2021·Neuromodulation : Journal of the International Neuromodulation Society·Cheng-Fu Wan, Tao Song