Namık ÖZCAN, Ayşe ÖZCAN, Ayşegül CEYHAN, Solmaz GÜNAL

Akut herpes zoster ağrısı ve postherpetik nevraljinin sinir bloğu ile tedavisi ve postherpetik nevralji gelişiminin engellenmesi

Amaç: Bu çalışma zona zoster sonrası gelişen şiddetli ağrının ve postherpetik nevraljinin sempatik blok ile tedavisi ve postherpetik nevralji gelişimini engellemesindeki etkinliğini araştırmak üzere retrospektif olarak gerçekleştirilmiştir. Metod: Çalışmada değişik lokalizasyonlu zona zoster lezyonları ve şiddetli ağrısı olan 37 hasta incelenmiştir. 4 hastaya servikal, 13 hastaya paravertebral, 8 hastaya Stellat ganglion, 12 hastaya interkostal blok uygulanmıştır. Bulgular: 35 hastada 1-3 seans, 1 hastada 5,1 hastada 6 seans blokla tam ağrısızhk elde edilmiştir. Sonuç: Sonuç olarak herpes zoster ağrısının sempatik sinir bloğu ile etkin biçimde tedavi edildiği ve postherpetik nevralji gelişimini engellediği kanaatine varılmıştır.

Treatment of acute herpes zoster pain and postherpetic neuralgia with neural block and prevention of development of postherpetic neuralgia

Treatment of Acute Herpes Zoster Pain And Postherpetic Neuralgia With Neural Block And Prevention of Development of Postherpetic Neuralgia Purpose: This study was performed retrospectively to evaluate the treatment of pain due to zona zoster and postherpetic neuralgia and prevention of postherpetic neuralgia with sympathetic blockade. Methods: Thirty-seven patients with zona zoster lesions in different localizations and severe pain were enrolled in this study. Cervical blockade was performed in 4 patients, paravertebral blockade in 13 patients, stellate ganglion blockade in 8 patients and intercostal blockade in 12 patients. Results: Complete pain relief was achieved in 35 patients with 1-3 block sessions, in 1 patient with 5 block sessions and in 1 patient with 6 block sessions. Conclusion: Herpes zoster pain was treated effectively and the development of postherpetic neuralgia was prevented successfully with sympathetic blockade.

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Bonica JJ. Causalgia and other reflex sympathetic dystrophies, in: Bonica JJ, Liebeskind JC, Fessard D, (eds), Advances in Pain Research and Therapy. New York: Raven Press; 1979.p. 141-166.
Rosenak S. Procaine injection treatment of herpes zoster. Lancet 1938; 2: 1056-1058.
Erdine S. Rejyonel anestezide kullanılan diğer bloklar .in. Sinir Blokları. İstanbul: Emre Matbaacılık 1993.p. 145-153
Yegül İ. Herpes zoster ve postherpetic nevralji.In. Ağrı ve Tedavisi. İzmir: Yapım Matbaacılık; 1993. p. 67-70.
Colding A. Treatment of pain: Organization of a pain clinic: Treat ment of acute herpes zoster. Proc R Soc Med 1973; 66: 541-543.
Conover WJ. Practical Nonparametric Statistics. New York: John Wiley & Sons; 1971.p. 140-149.
Selander D, Mansson LG, Karlsson L, Svanvik J. Adrenergic vasoconstriction in peripheral nerves of the rabbit. Anesthesiology 1985; 62: 6-10.
Lundborg G. Structure and function of the intraneural microvessels as related to trauma, edema formation, and nerve function. J Bone Joint Surg Am 1975; 57: 938-948.
Fink BR, Cairns AM. A bioenergetic basis for peripheral nerve fiber dissociation. Pain 1982; 12: 307-317.
Fink BR, Cairns AM. Differential tolerance of mammal in myelinated and unmyelinated nerve fibers to oxygen lack. Reg Anesth 1982;7:2-6.
Winnie AP, Hartwell PW Relationship between time of treatment of acute herpes zoster with sympathetic blockade and prevention of post-herpetic neuralgia: Clinical support for a new theory of the mechanism by which sympathetic blockade provides therapeutic benefit. Reg Anesth 1993; 18: 277-282.
McKendrick MW, McGill JI, Wood MJ. Lack of effect of acyclovir on postherpetie neuralgia. BMJ 1989; 298: 431.
Tenicella R, Lovasik D, Eaglstein W. Treatment of herpes zoster with sympathetic blocks. Clin J Pain 1985; 1: 63-67.
Currey TA, Dalsania J. Treatment for herpes zoster ophthalmicus: Stellate ganglion block as a treatment for acute pain and prevention of postherpetie neuralgia. Ann Ophthalmol 1991; 23: 188-189.
Coghlan CJ. Herpes zoster treated by acupuncture. Cent Afr J Med 1992; 38: 466-467.
Wu CL, Marsh A, Dworkin RH. The role of sympathetic nerve blocks in herpes zoster and postherpetie neuralgia. Pain 2000; 87: 121-129.