Abstract:
BACKGROUND:Postherpetic neuralgia, a persistent pain condition often characterized by allodynia and hyperalgesia, is a deleterious consequence experienced by patients after an acute herpes zoster vesicular eruption has healed. The pain associated with postherpetic neuralgia can severely affect a patient's quality of life, quality of sleep, and ability to participate in activities of daily living. Currently, first-line treatments for this condition include the administration of medication therapies such as tricyclic antidepressants, pregabalin, gabapentin, and lidocaine patches, followed by the application of tramadol and capsaicin creams and patches as second- or third-line therapies. As not all patients respond to such conservative options, however, interventional therapies are valuable for those who continue to experience pain. OBJECTIVE:This review focuses on interventional therapies that have been subjected to randomized controlled trials for the treatment of postherpetic neuralgia, including transcutaneous electrical nerve stimulation; local botulinum toxin A, cobalamin, and triamcinolone injection; intrathecal methylprednisolone and midazolam injection; stellate ganglion block; dorsal root ganglion destruction; and pulsed radiofrequency therapy. STUDY DESIGN:Systematic review. SETTING:Hospital department in Taiwan. METHODS:Search of PubMed database for all randomized controlled trials regarding postherpetic neuralgia that were published before the end of May 2017. RESULTS:The current evidence is insufficient for determining the single best interventional treatment. Considering invasiveness, price, and safety, the subcutaneous injection of botulinum toxin A or triamcinolone, transcutaneous electrical nerve stimulation, peripheral nerve stimulation, and stellate ganglion block are recommended first, followed by paravertebral block and pulsed radiofrequency. If severe pain persists, spinal cord stimulation could be considered. Given the destructiveness of dorsal root ganglion and adverse events of intrathecal methylprednisolone injection, these interventions should be carried out with great care and only following comprehensive discussion. LIMITATIONS:Although few adverse effects were reported, these procedures are invasive, and a careful assessment of the risk-benefit ratio should be conducted prior to administration. CONCLUSION:With the exception of intrathecal methylprednisolone injection for postherpetic neuralgia, the evidence for most interventional procedures used to treat postherpetic neuralgia is Level 2, according to "The Oxford Levels of Evidence 2". Therefore, these modalities have received only grade B recommendations. Despite the lack of a high level of evidence, spinal cord stimulation and peripheral nerve stimulation are possibly useful for the treatment of postherpetic neuralgia. KEY WORDS:Interventional treatment, postherpetic neuralgia, botulinum toxin, steroid, stellate ganglion block, peripheral nerve stimulation, paravertebral block, radiofrequency, spinal cord stimulation.
journal_name
Pain Physicianjournal_title
Pain physicianauthors
Lin CS,Lin YC,Lao HC,Chen CCsubject
Has Abstractpub_date
2019-05-01 00:00:00pages
209-228issue
3eissn
1533-3159issn
2150-1149journal_volume
22pub_type
杂志文章相关文献
Pain Physician文献大全abstract:BACKGROUND:Regenerative medicine is a medical subspecialty that seeks to recruit and enhance the body's own inherent healing armamentarium in the treatment of patient pathology. This therapy's intention is to assist in the repair, and to potentially replace or restore damaged tissue through the use of autologous or all...
journal_title:Pain physician
pub_type: 杂志文章,实务指引
doi:
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Prescription opioid analgesics (POA) are widely used in the pharmacotherapeutic treatment of acute and chronic pain in North America, where nonmedical prescription opioid use (NMPOU) has become a substantial public health concern in recent years. Existing epidemiological data suggest an association between N...
journal_title:Pain physician
pub_type: 杂志文章,meta分析,评审
doi:
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:The superior hypogastric plexus (SHGP) carries afferents from the viscera of the lower abdomen and pelvis. Neurolytic block of this plexus is used for reducing pain resulting from malignancy in these organs. The ganglion impar (GI) innervats the perineum, distal rectum, anus, distal urethra, vulva, and dista...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:The management of chronic pain is a complex challenge worldwide. Cannabis-based medicines (CBMs) have proven to be efficient in reducing chronic pain, although the topic remains highly controversial in this field. OBJECTIVES:This study's aim is to conduct a conclusive review and meta-analysis, which incorpo...
journal_title:Pain physician
pub_type: 杂志文章,meta分析,评审
doi:
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Acute pain is a risk factor for developing postherpetic neuralgia (PHN), the most common complication of herpes zoster (HZ). Supplemental analgesics are frequently used in the treatment of acute herpetic pain. However, there are insufficient data regarding when to begin supplemental analgesics, and it is unk...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Symptomatic lumbar spinal stenosis (LSS) patients often suffer from multiple etiologies, and patient symptoms must be differentiated and identified as either neurogenic claudication, radicular pain, or both. The most common symptom associated with LSS is neurogenic claudication, which has been reported to oc...
journal_title:Pain physician
pub_type: 临床试验,杂志文章
doi:
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Professional and pre-professional musicians are characterized by physical and psychological demands inherent to their musical activity, and therefore at risk for developing performance related musculoskeletal pain. Physical and psychological demands are known to influence human pain modulation. OBJECTIVES:I...
journal_title:Pain physician
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Discography has been widely used in the lumbar and cervical spine as a diagnostic tool to identify sources of discogenic pain that may be amenable to surgical treatment. Discography in the cervical spine is currently performed without the benefit of pressure monitoring, and corresponding pressure parameters ...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2005-04-01 00:00:00
abstract::In most cases of post-dural puncture headache, the positional symptoms will resolve spontaneously within 2 weeks. Conservative therapies include oral analgesics and hydration, bed rest, and abdominal binders. For refractory cases, an autologous epidural blood patch remains the treatment of choice. However, in certain ...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:The growth of interventional pain medicine in recent years has resulted in more procedures being carried out under fluoroscopic guidance. The proximity of the pain physician (PP) to ionization radiation (IR) potentially increases the risk of radiation exposure to the ocular region. A European directive has r...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Liposomal bupivacaine (LipoB), delivered via intercostal nerve blocks (ICNBs), is increasingly being used for postoperative pain control in thoracic surgery patients, but there is limited data on its effectiveness when compared to standard bupivacaine. OBJECTIVE:We sought to compare postoperative opioid use...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:A primary concern in the use of EBP in these patients is the possibility of seeding the virus in the CNS. Another important concern is related to the known hypercoagulable state in COVID-19 positive patients and associated organ dysfunction that may alter the metabolism of anticoagulants. The safety of the p...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Opioids are used extensively for chronic pain management in the United States. The frequency of opioid use prior to presenting to interventional pain management settings and in interventional pain management settings has been shown to be above 90%. Opioid abuse has been demonstrated in 9% to 41% of patients ...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:Postherpetic neuralgia (PHN) is often refractory to existing treatments. Pulsed radiofrequency (PRF) is known to be effective for treating neuropathic pain. In common, the targets of PRF treatment were the segmental dorsal root ganglion (DRG) neurons responsible for the pain. A potential complication that ca...
journal_title:Pain physician
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Elderly patients in general exhibit a higher incidence of chronic and neuropathic pain conditions. This group poses a particular clinical challenge due to age-related pharmacokinetic and pharmacodynamic issues, comorbid conditions, and polypharmacy, as well as frailty and cognitive decline. Poor control of p...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2015-09-01 00:00:00
abstract::There have been several case reports in the literature of neurolytic transversus abdominis plane (TAP) blocks being used for malignant abdominal wall pain. However, most used phenol as a neurolytic agent. We found only a single case report by Sakamoto using alcohol for TAP neurolysis. Unfortunately this patient passed...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:Occipital neuromodulation is a promising treatment modality for refractory headache, but lead migration remains a frequent surgical complication. OBJECTIVES:The primary objective was to identify surgical techniques that may minimize adverse events, particularly lead migration. We hypothesized that a surgica...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Individual response to opioid analgesics varies among patients. OBJECTIVE:This study sought to clarify the impact of distinct genetic variations on pain, opioid consumption, and opioid side effects in patients with postoperative pain. STUDY DESIGN:A systematic review and meta-analysis of associations betwe...
journal_title:Pain physician
pub_type: 杂志文章,meta分析,评审
doi:
更新日期:2015-03-01 00:00:00
abstract::When spinal injections are performed, a needle is placed in or around the spine making the risk of complications unavoidable. Spinal structures or adjacent organs are at risk for direct needle trauma, infection, hematoma, hemorrhage, nerve damage, stroke, allergic reaction, or spinal anesthesia with cardiorespiratory ...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:Both the Office of Inspector General (OIG) and reports from studies of the utilization of facet joint interventions have expressed that explosive increases in facet joint interventions provided to spinal pain patients are a major concern. STUDY DESIGN:The study is designed to assess the growth of facet join...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Many chronic pain patients (CPPs) cannot be cured of their pain, but can learn to manage it. This has led to research on pain "acceptance" which is defined as a behavior pattern with awareness of pain but not directed at changing pain. OBJECTIVE:CPPs who have accepted their pain generally acknowledge that a...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:The central analgesic tapentadol prolonged release (PR) has proven effective and generally well tolerated in a broad range of chronic pain conditions. Long-term data of its use are still scarce. OBJECTIVES:To evaluate long-term effectiveness, tolerability, and safety of tapentadol PR in patients with severe...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2021-01-01 00:00:00
abstract::Management of pain from skeletal metastases is notoriously difficult. Case reports and case series have described radiofrequency ablation of the obturator nerve branches to the femoral head for treatment of intractable hip pain. Ablation of the obturator branches to the femoral head is technically difficult because of...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Chronic neck pain is a common problem in the adult population with a typical 12-month prevalence of 30% to 50%, and 14% of the patients reporting grade II to IV neck pain with high pain intensity and disability that has a substantial impact on health care and society. Cervical epidural injections for managin...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:It is important to understand the anatomical relationship between the medial and lateral branches of superficial radial nerve (SRN) and the first dorsal compartment to prevent and minimize possible injury to these nerves during various procedures around the tip of radial styloid process (RSP). OBJECTIVE:To ...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Lumbar disc prolapse, protrusion, and extrusion are the most common causes of nerve root pain and surgical interventions, and yet they account for less than 5% of all low back problems. The typical rationale for traditional surgery is that it is an effort to provide more rapid relief of pain and disability. ...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Latent varicella zoster virus reactivates mainly in sensory ganglia such as the dorsal root ganglion (DRG) or trigeminal ganglion. The DRG contains many receptor channels and is an important region for pain signal transduction. Sustained abnormal electrical activity to the spinal cord via the DRG in acute he...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2017-03-01 00:00:00
abstract::Clinical outcome data was analyzed for 67 patients with contained disc herniation who underwent percutaneous disc decompression procedure using Coblation(R) technology, also referred to as Nucleoplasty after failing to respond to conservative management. Patients presented with clinical symptoms of discogenic low back...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:One of the most important issues that interventional physicians address during treatment is informing patients of their treatment options. Prior to beginning treatment, patients are given this information and allowed the opportunity to ask questions. Minimal qualitative information exists as to how much of t...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Fibromyalgia (FM) is a syndrome whose primary symptoms include chronic widespread muscle pain and fatigue. The treatment of patients with FM aims to provide symptomatic relief and improvement in physical capacities to perform daily tasks and quality of life. Invasive or non-invasive electric stimulation (ES)...
journal_title:Pain physician
pub_type: 杂志文章,meta分析,评审
doi:
更新日期:2017-02-01 00:00:00