Ultrasound-Guided Erectro Spinae Plane Block Versus Stellate Ganglion Block for Patients With Upper Limb Acute Herpes Zoster Pain: Randomized Controlled Study

Herpes zoster (HZ) is a painful, eruptive, viral condition results from reactivation of the latent varicella zoster virus after the primary infection. The selection of an effective analgesic method in the acute phase of herpes zoster can decrease the incidence of postherpetic neuralgia by reducing neural sensitization. The stellate ganglion is present in 80% of the general population and is composed of the inferior cervical ganglion and the first thoracic ganglion fusion. It lies anterior to the neck of the first rib and extends to the inferior aspect of the transverse process of C7. The erector spinae plane (ESP) block has been reported to provide diffuse and effective analgesia in the cervical, thoracic, and lumbar regions.

开始日期2024-03-01

申办/合作机构

Tanta University

ChiCTR2300078591 / Recruiting早期临床1期IIT

Clinical study of dorsal root ganglion pulse radiofrequency combined with sympathetic nerve radiofrequency in treatment of acute herpes zoster neuralgia

开始日期2024-01-01

申办/合作机构-

100 项与急性带状疱疹神经病相关的临床结果

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100 项与急性带状疱疹神经病相关的转化医学

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0 项与急性带状疱疹神经病相关的专利（医药）

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134

项与急性带状疱疹神经病相关的文献（医药）

2024-10-01·The Korean Journal of Pain

Assessment of ultrasound-guided intercostal nerve block for acute herpes zoster and its' possible prophylaxis for postherpetic neuralgia: a retrospective and case-controlled trial

Article

作者: Yuan, Rong ; Li, Xiuhua ; Yang, Yanwei ; Fu, Runqiao ; Qin, Zhenlong

BackgroundThis study aimed to compare the intercostal nerve block (ICNB) and thoracic paravertebral block (TPVB) for acute herpes zoster-associated pain (ZAP) and possible prophylaxis for post-herpetic neuralgia (PHN).MethodsThis study enrolled 128 patients with ZAP. Their records were stratified into standard antiviral treatment (AVT) plus US-guided TPVB (the TPVB group), AVT plus US-guided ICNB (the ICNB group) or AVT alone (the control group). Herpes zoster (HZ)-related burden of illness (HZ-BOI) within the post-procedural 30 days was defined as the primary endpoint, determined by a composite of pain severity and follow-up duration. Procedure time, rescue analgesic requirement, PHN incidence, health-related quality of life and side effects were also recorded.ResultsSignificantly lower HZ-BOI-AUC₃₀ was reported in the TPVB and ICNB groups as compared to the control group, with a mean difference of 57.5 (P < 0.001) and 40.3 (P = 0.003), respectively. However, there was no difference between the TPVB and ICNB groups (P = 0.978). Both TPVB and ICNB reported significantly greater improvements in PHN incidence, EQ-5D-3L scores and rescue analgesic requirements during follow-up, as opposed to the control AVT. Shorter procedure time was observed in ICNB as compared to TPVB (16.47 ± 3.39 vs. 11.69 ± 2.58, P < 0.001).ConclusionsBoth US-guided TPVBs and ICNBs were effective for ZAP, and accounted for possible prophylaxis for PHN, as compared to AVT alone. The ICNB approach could be recommended as an alternative to conventional TPVB with a better consumed procedure time and side effect profile.a.

2024-04-01·The Korean Journal of Pain

Efficacy of high-voltage, long-duration pulsed radiofrequency for the treatment of acute herpes zoster-related trigeminal neuralgia in a patient with permanent pacemaker

Article

作者: Liu, Yue ; Liu, Xiao-Dong ; Li, Li-Mei ; Liu, Ting-Ting ; Zhang, Zhi-Li

2024-02-01·The Journal of Dermatology

Efficacy and safety of intravenous fosphenytoin for patients with acute herpes zoster‐associated pain: A placebo‐controlled randomized trial

Article

作者: Majima, Yuta ; Amaya, Fumimasa ; Shimizu, Kenji ; Inafuku, Kazuhiro ; Arai, Saori ; Kosugi, Toshifumi ; Ogawa, Youichi ; Kawashima, Makoto ; Yamamoto, Takenobu ; Hamada, Toshihisa ; Deguchi, Tokiko ; Takahashi, Morito ; Hamada, Izumi ; Iseki, Masako ; Hasegawa, Toshio ; Abe, Yoichiro ; Watanabe, Daisuke ; Nomura, Yukiko ; Ishikawa, Yuko

AbstractAcute zoster‐associated pain develops in most patients with herpes zoster. Nonopioid analgesics are usually used to treat acute zoster‐associated pain but are frequently ineffective. We administered intravenous fosphenytoin, the prodrug of phenytoin, to patients with acute zoster‐associated pain to examine its analgesic efficacy and safety. At 13 medical institutions in Japan, we conducted a phase II, double‐blind, placebo‐controlled, randomized trial of intravenous fosphenytoin in Japanese inpatients with acute zoster‐associated pain for whom nonopioid analgesics had shown an insufficient analgesic effect. The patients were randomly assigned (1:1:1) to receive a single intravenous dose of fosphenytoin at 18 mg/kg (high dose), a single intravenous dose of fosphenytoin at 12 mg/kg (low dose), or placebo. The primary endpoint was the mean change per hour (slope) in the numerical rating scale score from the baseline score until 120 min after dosing. Seventeen patients were randomly assigned to the low‐dose fosphenytoin group (n = 6, median age 62.5 years, range 39–75 years), high‐dose fosphenytoin group (n = 5, median age 69.0 years, range 22–75 years), and placebo group (n = 5, median age 52.0 years, range 38–72 years). One patient was excluded because of investigational drug dilution failure. This study was discontinued because of the influences of coronavirus disease 2019. The slope was significantly lower in the high‐ and low‐dose fosphenytoin groups than in the placebo group (P < 0.001 and P = 0.016, respectively). Responsiveness to intravenous fosphenytoin (≥2‐point reduction in the numerical rating scale score from baseline to 120 min after dosing) was inferred at plasma total phenytoin concentrations of 10–15 μg/mL. Treatment‐emergent adverse events caused no safety concerns in the clinical setting and intravenous fosphenytoin was well tolerated. Intravenous fosphenytoin appears to be an effective and promising alternative treatment for acute zoster‐associated pain.Trial Registration: ClinicalTrials.gov NCT04139330.