TY - JOUR
T1 - Efficacy of continuous epidural block in acute herpes zoster
T2 - Incidence and predictive factors of postherpetic neuralgia, a retrospective single-center study
AU - Kim, Yoo Na
AU - Kim, Dae Woo
AU - Kim, Eung Don
N1 - Publisher Copyright:
Copyright © 2016 the Author(s). Published by Wolters Kluwer Health, Inc. All rights reserved.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - The aim of the present study was to investigate efficacy of continuous epidural block for prevent postherpetic neuralgia (PHN) progression in cases of acute herpes zoster with severe pain and also to identify predictive factors for PHN in such conditions. We retrospectively analyzed the clinical data of patients with herpes zoster who underwent continuous epidural block between March 2013 and October 2015. Time points were set as 1 month, 3 months, and 6 months after zoster onset. PHN was defined as the presence of pain with NRS ≥3 at certain time points. The incidence of developing PHN was 38.1%, 27.0%, and 19.0% 1 month, 3 months, and 6 months after zoster onset, respectively. Age and duration of catheterization were predictive factors for PHN at 1 month. Age, duration of catheterization, and NRS at first visit were identified as predictive factors for PHN at 3 months. Presence of diabetes, duration of catheterization, and NRS during catheterization were significant predictive factors for PHN at 6 months. The incidence of PHN is higher in zoster patients with severe pain that requires continuous epidural block compared to incidence in the general population. Advanced age and severe initial pain intensity were predictive factors of PHN development. Prolonged catheterization resulting from weak response to treatment strongly suggested progression to PHN.
AB - The aim of the present study was to investigate efficacy of continuous epidural block for prevent postherpetic neuralgia (PHN) progression in cases of acute herpes zoster with severe pain and also to identify predictive factors for PHN in such conditions. We retrospectively analyzed the clinical data of patients with herpes zoster who underwent continuous epidural block between March 2013 and October 2015. Time points were set as 1 month, 3 months, and 6 months after zoster onset. PHN was defined as the presence of pain with NRS ≥3 at certain time points. The incidence of developing PHN was 38.1%, 27.0%, and 19.0% 1 month, 3 months, and 6 months after zoster onset, respectively. Age and duration of catheterization were predictive factors for PHN at 1 month. Age, duration of catheterization, and NRS at first visit were identified as predictive factors for PHN at 3 months. Presence of diabetes, duration of catheterization, and NRS during catheterization were significant predictive factors for PHN at 6 months. The incidence of PHN is higher in zoster patients with severe pain that requires continuous epidural block compared to incidence in the general population. Advanced age and severe initial pain intensity were predictive factors of PHN development. Prolonged catheterization resulting from weak response to treatment strongly suggested progression to PHN.
KW - continuous epidural
KW - herpes zoster
KW - postherpetic neuralgia
KW - predictive factor
UR - http://www.scopus.com/inward/record.url?scp=84983433164&partnerID=8YFLogxK
U2 - 10.1097/MD.0000000000004577
DO - 10.1097/MD.0000000000004577
M3 - Article
C2 - 27512887
AN - SCOPUS:84983433164
SN - 0025-7974
VL - 95
JO - Medicine (United States)
JF - Medicine (United States)
IS - 32
M1 - e4577
ER -