The 68th
Scientific Meeting
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| 19S-007 |
Efficacy of continuous epidural block with epidural electrical stimulation in acute herpes zoster: A retrospective study
고려대학교 구로병원 마취통증의학교실
Background and objectives: Continuous epidural block is known to be effective in controlling pain and preventing postherpetic neuralgia [1]. However, in conventional continuous epidural block, location of epidural catheter is confirmed only based on the diffusion pattern of the contrast agent.
Objectives: The purpose of this study was to compare the efficacy of conventional continuous epidural block and continuous epidural block, which involves the identification of the areas showing neurological damage using epidural electrical stimulation, in the treatment of herpes zoster pain and prevention of postherpetic neuralgia.
Materials and methods: Medical records of the patients who underwent continuous epidural block due to herpes zoster pain from June 2010 to October 2017 were collected. Among them, we analyzed 114 patients in this study (Figure 1). Patients were divided into two groups: esopocan group (conventional continuous epidural block) and epistim group (continuous epidural block with epidural electric stimulation). Clinical efficacy was assessed using a numerical rating scale (pain score) up to six months after the procedures. We compared the percentage of patients with complete remission (pain score less than 2 and no further medication) in each group. We also investigated whether the patients underwent additional interventional treatment due to insufficient pain control during the 6-month follow-up period after each procedure.
Results: After adjusting for each variable, the pain score was significantly lower in the epistim group than in the esopocan group for 6 months after the procedure (Table 1). The adjusted odds ratio of the patients included in the complete remission category was 1.9 times higher in the epistim group than in the esopocan group (P = 0.14). The adjusted odds ratio for other intervention procedures within 6 months after the procedure (esopocan group versus epistim group) was 3.62 (P = 0.03).
Conclusions: Epidural drug administration to specific segments using electric stimulation catheters may be more helpful in improving herpes zoster pain and preventing postherpetic neuralgia in acute herpes zoster.
Reference
1. Kim HJ, Ahn HS, Lee JY, et al. Effects of applying nerve blocks to prevent postherpetic neuralgia in patients with acute herpes zoster: a systematic review and meta-analysis. Korean J Pain. 2017;30:3
Objectives: The purpose of this study was to compare the efficacy of conventional continuous epidural block and continuous epidural block, which involves the identification of the areas showing neurological damage using epidural electrical stimulation, in the treatment of herpes zoster pain and prevention of postherpetic neuralgia.
Materials and methods: Medical records of the patients who underwent continuous epidural block due to herpes zoster pain from June 2010 to October 2017 were collected. Among them, we analyzed 114 patients in this study (Figure 1). Patients were divided into two groups: esopocan group (conventional continuous epidural block) and epistim group (continuous epidural block with epidural electric stimulation). Clinical efficacy was assessed using a numerical rating scale (pain score) up to six months after the procedures. We compared the percentage of patients with complete remission (pain score less than 2 and no further medication) in each group. We also investigated whether the patients underwent additional interventional treatment due to insufficient pain control during the 6-month follow-up period after each procedure.
Results: After adjusting for each variable, the pain score was significantly lower in the epistim group than in the esopocan group for 6 months after the procedure (Table 1). The adjusted odds ratio of the patients included in the complete remission category was 1.9 times higher in the epistim group than in the esopocan group (P = 0.14). The adjusted odds ratio for other intervention procedures within 6 months after the procedure (esopocan group versus epistim group) was 3.62 (P = 0.03).
Conclusions: Epidural drug administration to specific segments using electric stimulation catheters may be more helpful in improving herpes zoster pain and preventing postherpetic neuralgia in acute herpes zoster.
Reference
1. Kim HJ, Ahn HS, Lee JY, et al. Effects of applying nerve blocks to prevent postherpetic neuralgia in patients with acute herpes zoster: a systematic review and meta-analysis. Korean J Pain. 2017;30:3
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