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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
Affiliations- Pain Clinic: Department of Anesthesiology and Intensive Care, Medical Center for Postgraduate Education, Warsaw, Poland
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Abstract
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 methodsThis 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.
ResultsThe 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.
ConclusionIt 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
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 methodsThis 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.
ResultsThe 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.
ConclusionIt 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.
Keywords
Postherpetic neuralgia, Numeric rating scale, Sympathetic nerve block, Gabapentin, Tricyclic antidepressant
About this articleTitle
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
Pages
24-28
Page views
421
Article views/downloads
597
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
