open access

Vol 49, No 1 (2015)
Original research articles
Submitted: 2014-11-20
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5% lidocaine medicated plasters vs. sympathetic nerve blocks as a part of multimodal treatment strategy for the management of postherpetic neuralgia: A retrospective, consecutive, case-series study

Małgorzata Malec-Milewska, Bartosz Horosz, Agnieszka Sękowska, Iwona Kolęda, Hanna Kucia, Dariusz Kosson
DOI: 10.1016/j.pjnns.2015.01.001
·
Neurol Neurochir Pol 2015;49(1):24-28.

open access

Vol 49, No 1 (2015)
Original research articles
Submitted: 2014-11-20

Abstract

Introduction

5% lidocaine medicated plasters (5% LMP) have been appointed as a first-line treatment for post-herpetic neuralgia (PHN), while formerly used sympathetic nerve blocks (SNBs) were recently denied their clinical efficacy. The aim of this study was to compare the results of PHN management with the use of SNBs and 5% LMP as a first-line treatment.

Material and methods

This study was designed as a retrospective, consecutive, case-series study. Data of 60 consecutive PHN patients with allodynia treated with the use of SNBs and 60 subsequent patients managed with 5% LMP were analyzed. Pain severity after 8 weeks was assessed to recognize the results of the implemented therapy, with numeric rating scale (NRS) score <3 or =3 considered a success. Additionally, the number of pain-free patients (NRS=0) after 8 weeks were identified in both groups and compared.

Results

The rate of failures in SNBs and 5% LMP group was similar (18.9% vs. 27.1% of poor treatment results, respectively), with the average change in NRS of 5.88±2.41 in nerve blocks and 5.01±1.67 in lidocaine group (p=0.02). Significant difference was also noted in the rates of pain-free patients: 20 patients (34.4%) treated with SNBs and 8 (13.5%) using 5% LMP were pain-free after 8 weeks of treatment.

Conclusion

It may be concluded that SNBs may still be considered useful in PHN management, as it appears that in some cases this mode of treatment may offer some advantages over 5% LMP.

Abstract

Introduction

5% lidocaine medicated plasters (5% LMP) have been appointed as a first-line treatment for post-herpetic neuralgia (PHN), while formerly used sympathetic nerve blocks (SNBs) were recently denied their clinical efficacy. The aim of this study was to compare the results of PHN management with the use of SNBs and 5% LMP as a first-line treatment.

Material and methods

This study was designed as a retrospective, consecutive, case-series study. Data of 60 consecutive PHN patients with allodynia treated with the use of SNBs and 60 subsequent patients managed with 5% LMP were analyzed. Pain severity after 8 weeks was assessed to recognize the results of the implemented therapy, with numeric rating scale (NRS) score <3 or =3 considered a success. Additionally, the number of pain-free patients (NRS=0) after 8 weeks were identified in both groups and compared.

Results

The rate of failures in SNBs and 5% LMP group was similar (18.9% vs. 27.1% of poor treatment results, respectively), with the average change in NRS of 5.88±2.41 in nerve blocks and 5.01±1.67 in lidocaine group (p=0.02). Significant difference was also noted in the rates of pain-free patients: 20 patients (34.4%) treated with SNBs and 8 (13.5%) using 5% LMP were pain-free after 8 weeks of treatment.

Conclusion

It may be concluded that SNBs may still be considered useful in PHN management, as it appears that in some cases this mode of treatment may offer some advantages over 5% LMP.

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Keywords

Postherpetic neuralgia, Numeric rating scale, Sympathetic nerve block, Gabapentin, Tricyclic antidepressant

About this article
Title

5% lidocaine medicated plasters vs. sympathetic nerve blocks as a part of multimodal treatment strategy for the management of postherpetic neuralgia: A retrospective, consecutive, case-series study

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 49, No 1 (2015)

Pages

24-28

DOI

10.1016/j.pjnns.2015.01.001

Bibliographic record

Neurol Neurochir Pol 2015;49(1):24-28.

Keywords

Postherpetic neuralgia
Numeric rating scale
Sympathetic nerve block
Gabapentin
Tricyclic antidepressant

Authors

Małgorzata Malec-Milewska
Bartosz Horosz
Agnieszka Sękowska
Iwona Kolęda
Hanna Kucia
Dariusz Kosson

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