PDF(Pubmed)
Abstract：
Background and Objectives: Achieving adequate pain reduction in the acute phase of herpes zoster is essential for preventing postherpetic neuralgia (PHN). For this purpose, appropriate antiviral medications, oral analgesic medications, and various nerve block methods could be applied. Erector spinae plane block (ESPB) is a simple, novel ultrasound-guided block technique, and its use has increased because the procedure is convenient and relatively safe. Although several cases have reported the zoster-associated pain (ZAP) control effect of ESPB, the efficacy of ESPB has not been compared with that of other types of nerve blocks for managing ZAP. This study aimed to compare the efficacy of ESPB with that of other types of nerve blocks for managing ZAP. Study Design: Retrospective case-control study. Materials and Methods: Medical records of 53 patients with acute thoracic herpes zoster were reviewed. We divided the participants into two groups: patients who received transforaminal epidural injection (TFEI) (n = 32) and those who received ESPB (n = 21). The efficacy of the procedure was assessed by a numerical rating scale (NRS) and by recording patient medication doses before the procedure and at 1 week, 1 month, 2 months, and 3 months after the procedure. Results: The time required for pain intensity to decrease to NRS ≤ 2 was not significantly different between the groups. The rate of medication discontinuation also was not different between the groups. There was no significant difference between the two groups in the proportion of clinically significant PHN (NRS ≥ 3) at any time point. Limitations: The relatively small sample size from a single center and the retrospective nature of the study served as limitations. Conclusions: The clinical effects of ESPB and TFEI were similar in patients with acute thoracic herpes zoster. ESPB could be considered an interventional option for ZAP management.
摘要：
背景和目的：在带状疱疹急性期实现充分的疼痛减轻对于预防带状疱疹后遗神经痛（PHN）至关重要。为此,适当的抗病毒药物，口服镇痛药，可以应用各种神经阻滞方法。平立脊平面块(ESPB)是一种简单的，新颖的超声引导阻滞技术，由于该程序方便且相对安全，因此其使用有所增加。尽管一些病例报道了ESPB的带状疱疹相关性疼痛（ZAP）控制效果，尚未将ESPB的疗效与其他类型的神经阻滞治疗ZAP的疗效进行比较.这项研究旨在比较ESPB与其他类型的神经阻滞治疗ZAP的疗效。研究设计：回顾性病例对照研究。材料与方法：回顾性分析53例急性胸廓带状疱疹患者的临床资料。我们将参与者分为两组：接受经椎间孔硬膜外注射（TFEI）的患者（n=32）和接受ESPB的患者（n=21）。通过数字评定量表（NRS）并在手术前和手术1周时记录患者的药物剂量来评估手术的有效性。1个月,2个月,手术后3个月。结果：疼痛强度降低至NRS≤2所需的时间在两组之间没有显着差异。两组之间的停药率也没有差异。两组在任何时间点的有临床意义的PHN（NRS≥3）的比例均无显着差异。局限性：来自单个中心的相对较小的样本量和研究的回顾性性质是局限性。结论：ESPB和TFEI对急性胸廓带状疱疹患者的临床疗效相似。ESPB可以被认为是ZAP管理的干预选择。
