Tumescent Infiltration of Corticosteroids, Lidocaine, and Epinephrine Into Dermatomes of Acute Herpetic Pain or Postherpetic Neuralgia

Chiarello, Stephen E.

doi:10.1001/archderm.134.3.279

Cited by 14 publications

(2 citation statements)

References 13 publications

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“…It is controversial that conventional therapy alone or in combination with systemic corticosteroids and/or nerve block may be of some benefit for preventing PHN. Chiarello (26) challenged tumescent infiltration of corticosteroids, lidocaine, and epinephrine into dermatomes, with overall positive results for acute herpetic pain but inconstant results for PHN. The concentration of lidocaine he used was diluted to 0.05% with 1:1,000,000 epinephrine in a normal saline solution, and the amount of anesthetic solution injected was from 100 to 1,000 mL.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors of Postherpetic Neuralgia

Herr

2002

J Korean Med Sci

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The investigation was aimed to determine prognostic factors related to postherpetic neuralgia (PHN), and treatment options for preventing PHN. The data showed 34 (17.0%) out of 188 patients with herpes zoster had severe pain after 4 weeks, and 22 (11.7%) after 8 weeks, compared with 109 (58.0%) at presentation. The age (≥50 yr), surface area involved (≥9%), and duration of severe pain (≥4 weeks) might be the main factors that lead to PHN. On the other hand, gender, dermatomal distribution, accompanied systemic conditions, and interval between initial pain and initiation of treatment might not be implicated in PHN. The subjects were orally received antiviral (valacyclovir), tricyclic antidepressant (amitriptyline), and analgesic (ibuprofen) as the standard treatment in the group 1. In addition to the standard medication, lidocaine solution was sub-and/or perilesionally injected in the group 2, while lidocaine plus prilocaine cream was topically applied to the skin lesions in the group 3. The rates of PHN in the 3 treatment groups were not significantly different, suggesting adjuvant anesthetics may not be helpful to reduce the severity of pain.

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Section: Discussionmentioning

confidence: 99%

Prognostic Factors of Postherpetic Neuralgia

Herr

2002

J Korean Med Sci

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“…Although the data is compelling, there is a need for large controlled trials to provide the clinical justification for these invasive approaches. Similarly, subcutaneous infiltration of affected dermatomes with local anesthetic and/or corticosteroids has also shown promise in reducing the pain of PHN in uncontrolled trials and warrants further investigation [53,54].…”

Section: Miscellaneousmentioning

confidence: 99%

The cancer patient with chronic pain due to herpes zoster

Modi¹,

Pereira

Mackey³

2000

Current Review of Pain

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Postherpetic neuralgia (PHN) is the most common complication of herpes zoster, and as such has been an area of extensive medical research for the past three decades. The patients at highest risk for PHN include those older than 50 years, those with severe acute cases of zoster, and those with shingles in a trigeminal distribution. As persons with malignancy are at a high risk for developing zoster itself, PHN is a complication that will be faced by many of these patients and their caregivers. This article reviews the available treatments and preventative measures for this debilitating condition.

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Research Priorities in Geriatric Anesthesiology

Jankowski

Cook

Geriatric Anesthesiology

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Tumescent Infiltration of Corticosteroids, Lidocaine, and Epinephrine Into Dermatomes of Acute Herpetic Pain or Postherpetic Neuralgia

Cited by 14 publications

References 13 publications

Prognostic Factors of Postherpetic Neuralgia

Prognostic Factors of Postherpetic Neuralgia

The cancer patient with chronic pain due to herpes zoster

Research Priorities in Geriatric Anesthesiology

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