GÜLÇİN HACIBEYOĞLU, ŞULE ARICAN, Sinan Oğuzhan ULUKAYA, RESUL YILMAZ, Ruhiye REİSLİ, SEMA TUNCER UZUN

Evaluation of the efficacy of erector spinae plane block and intercostal nerve block in the postherpetic neuralgia

Objectives: The aim of this study was to compare the efficacy of an intercostal nerve block, which has been used for manyyears in the treatment of postherpetic neuralgia, and the more recent alternative of an erector spinae plane (ESP) block.Methods: The records of 39 patients who were treated in the algology department for postherpetic neuralgia between May1, 2015 and May 1, 2018 were evaluated retrospectively. Patients who received an intercostal nerve block constituted Group1 and those who received an ESP block were categorized as Group 2. The change in numeric rating scale (NRS) and Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scores in the short term and in the long term were the primary resultsof the study.Results: The NRS, LANSS, and sleep interference scale (SIS) scores of the patients in Group 1 and Group 2 were found to besignificantly lower at the 24th hour, week 4, and week 12 compared with the values obtained before block application. In Group1, the scores recorded at week 4 and week 12 were significantly higher than the 24th hour values, whereas no difference wasobserved between these results in Group 2. There was no significant difference between the groups in the week 4 and week 12scores. Similarly, no significant difference was observed in the NRS, LANSS, or SIS scores before the block application or at the24th hour. However, the scores at week 4 and week 12 were significantly lower in Group 2 compared with Group 1.Conclusion: The results indicated that an ESP block significantly decreased neuropathic pain symptoms and the need for additional treatment in postherpetic neuralgia treatment in the long term.

Postherpetik nevraljide erektör spina plan blok ve interkostal sinir bloğu etkinliğinin değerlendirilmesi

Amaç: Bu çalışmada postherpetik nevralji tedavisinde uzun yıllardır kullanılan interkostal sinir bloğu ile yakın zamanda tanımlanan erektör spina düzlem bloğunun etkinliğinin kıyaslanması amaçlanmıştır. Gereç ve Yöntem: 1 Mayıs 2015–1 Mayıs 2018 tarihleri arasında Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Algoloji Kliniği’nde postherpetik nevralji nedeniyle tedavi görmüş 39 hasta dosyası retrospektif olarak değerlendirildi. İnterkostal sinir bloğu yapılanlar Grup 1, erektör spina düzlem bloğu yapılanlar Grup 2 olarak kabul edildi. Kısa dönem ve uzun dönemde NRS ve LANSS skorlarındaki değişim çalışmanın birincil sonuçları olarak kabul edildi. Bulgular: Grup 1 ve Grup 2’deki hastaların NRS, LANSS ve uyku interferans (SIS) skorlarının 24. saat, 4. hafta ve 12. hafta değerleri blok öncesine göre anlamlı derecede düşüktü. Grup 1’deki hastaların 4. hafta ve 12. hafta değerleri 24. saat değerlerine göre anlamlı derecede yüksekken Grup 2’deki hastalarda bu değerler arasında fark yoktu. 4. ve 12. hafta değerleri arasında da her iki grupta anlamlı fark yoktu. Benzer şekilde, gruplar arasında NRS, LANSS ve SIS skorları açısından blok uygulamasından önce ve 24 saat sonra anlamlı bir fark gözlenmedi. Ancak 4. ve 12. haftalardaki puanlar Grup 2’de Grup 1’e göre anlamlı olarak düşüktü. Sonuç: Bu çalışma postherpetik nevralji tedavisinde erektör spina düzlem bloğunun özellikle uzun dönemde nöropatik ağrı semptomları ile ek tedavi ihtiyacını belirgin azalttığını göstermiştir.

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