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 unknown whether the delayed use of supplemental analgesics increases the risk of PHN in high-risk patients. OBJECTIVES:This study aimed to evaluate the association between initial time of supplemental pain management and the risk of PHN in high-risk patients. STUDY DESIGN:Retrospective study. SETTING:The Department of Anesthesiology and Pain Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine. METHODS:We performed a retrospective study between May 13, 2017 and August 8, 2018 in our clinic. Multivariable logistic regression analysis was conducted to examine the independent factors associated with PHN. Supplemental pain management was defined as any use of opioids, tricyclic antidepressants, or nerve blocks. A subgroup analysis was conducted in patients who received supplemental pain management within the first 30 days of onset. According to the initial time of supplemental pain management, patients were divided into 2 groups: the early treatment group (<= 14 days), and the late treatment group (> 14 days). The clinical outcomes in these 2 groups was compared for propensity score (PS) matching. RESULTS:A total of 134 patients with HZ aged 50 years or older with moderate to severe pain were enrolled in this study. The delayed initiation of supplemental pain management (> 14 days) (odds ratio, 4.11; 95% confidence interval, 1.69-9.92; P = 0.002) and severity of rash (odds ratio, 2.93; 95% confidence interval, 1.22-7.01; P = 0.016) were independent factors associated with PHN. In the subgroup analysis, after PS matching, there were no significant differences in the baseline clinical parameters between the early and late treatment groups. The incidence of PHN was significantly lower in the early treatment group than the late treatment group (36. 4% vs. 72.7%; P = 0.015). Reduction in pain was also greater in the early treatment group. LIMITATIONS:The findings identified in the present study are specific to the patients who were relatively older and with moderate to severe pain. It is impossible to determine from our study whether younger individuals and individuals with mild acute pain will benefit from early supplemental treatments. Furthermore, because of the retrospective nature of the study, there may be some confounders that could not be controlled. Further prospective studies with larger sample sizes and longer follow-up periods are needed. CONCLUSIONS:The early use of supplemental pain management may decrease the risk of PHN. It might therefore be beneficial to consider administering supplemental pain management earlier in older patients with moderate to severe acute herpetic pain. KEY WORDS:Herpes zoster, postherpetic neuralgia, analgesia, opioid, nerve block, tricyclic antidepressant.
journal_name
Pain Physicianjournal_title
Pain physicianauthors
Xing X,Sun K,Yan Msubject
Has Abstractpub_date
2020-01-01 00:00:00pages
65-72issue
1eissn
1533-3159issn
2150-1149journal_volume
23pub_type
杂志文章相关文献
Pain Physician文献大全abstract:BACKGROUND:Zygapophysial or facet joint pain in patients suffering with chronic spinal pain without disc herniation or radiculopathy may be diagnosed with certainty by the use of controlled diagnostic blocks. But, in patients suffering with either lumbar or cervical facet joint pain, even this diagnostic approach may b...
journal_title:Pain physician
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2006-01-01 00:00:00
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:Evidence of a paradigm shift towards epicranial neurostimulation treatment techniques aimed at the site of headache pain is beginning to populate the literature. This is most apparent by 2 recently published reports describing alternative approaches to peripheral nerve stimulation techniques for refractory m...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2011-01-01 00:00:00
abstract::A peripheral nerve stimulator (PNS) can be an alternative for long-term pain relief refractory to conventional therapeutic modalities. We present a case of chronic incapacitating ilioinguinal neuralgia, which was successfully managed with permanent implantation of a peripheral nerve stimulator. A 26-year-old active du...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Percutaneous endoscopic cervical discectomy has evolved as an efficient, minimally invasive spine surgery for radiculopathy caused by soft and/or osseous foraminal stenosis. Although interlaminar access can be used to resect lateral herniated lesions or osteophytes located in the foramina, with limited opera...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2019-09-01 00:00:00
abstract:STUDY DESIGN:Electrical stimulation of the right cervical medial branches with or without the third occipital nerves was performed in nine subjects for a total of forty-eight medial branches and eight third occipital nerves. The referral patterns of each nerve or nerve branch was mapped on a human line diagram. These d...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:The rapid increase in the prevalence of chronic pain and disability, and the explosion of interventional pain management associated health care costs are a major concern for our community. Further, the increasing utilization of numerous modalities of treatments in managing chronic pain, continue to escalate ...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Breast cancer-related lymphedema (BCRL) not only has physical implications, but also affects the quality of life in breast cancer survivors. Despite numerous studies of various therapies, the optimal treatment for BCRL is unknown. OBJECTIVE:In this study, we investigated the efficacy of sympathetic blockade...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Opioid abuse has continued to increase at an alarming rate since our last opioid guidelines were published in 2005. Available evidence suggests a continued wide variance in the use of opioids, as documented by different medical specialties, medical boards, advocacy groups, and the Drug Enforcement Administra...
journal_title:Pain physician
pub_type: 杂志文章,实务指引,评审
doi:
更新日期:2008-03-01 00:00:00
abstract::Over the past 2 decades, the issue of fetal pain and stress has attracted considerable attention and has become the focus of ongoing debate in light of advances in medical diagnostics and technology that allow invasive prenatal medical intervention(s), and an enhanced understanding of fetal neurophysiology, together w...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:The trends of the expenditures of facet joint interventions have not been specifically assessed in the fee-for-service (FFS) Medicare population since 2009. OBJECTIVE:The objective of this investigation is to assess trends of expenditures and utilization of facet joint interventions in FFS Medicare populati...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:The activation of mitogen-activated protein kinases (MAPKs) have been observed in synaptic plasticity processes of learning and memory in neuropathic pain. Cerebrospinal fluid-contacting nucleus (CSF-CN) has been identified with the onset and persistence of neuropathic pain. However, whether extracellular si...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:It is still a challenge to optimize postoperative pain management. The effects of adding dexmedetomidine (DEX) to opioid-based postoperative intravenous patient-controlled analgesia (PCA) are not fully understood. OBJECTIVES:The aim of this study is to assess the efficacy and safety of opioid-DEX combinatio...
journal_title:Pain physician
pub_type: 杂志文章,meta分析,评审
doi:
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Before long-term intrathecal analgesic therapy is initiated, patients often undergo a spinal analgesia trial. Ziconotide is a nonopioid intrathecal analgesic used to manage severe chronic pain, and a variety of methods have been used to trial ziconotide. OBJECTIVES:The purpose of this review is to compare a...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2010-01-01 00:00:00
abstract::The lifetime prevalence of spinal pain has been reported as 65% to 80% in the neck and low back. In the US each year, 500,000 - 1,000,000 spine surgeries and 2 to 5 million interventional procedures are estimated to be performed. The burden created by chronic pain is enormous on the patient and society. Thus, the soma...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:Understanding the mechanisms of long-standing musculoskeletal pain and adaptations in response to physical rehabilitation is important for developing optimal treatment strategies. The influence of central adaptations of pain perception in response to rehabilitation of musculoskeletal pain remains unclear. O...
journal_title:Pain physician
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:The increase in the utilization of various techniques in managing chronic pain, including interventional techniques, is a major concern for policy-makers and the public at large. Consequently, multiple regulations have been instituted to reduce health care expenditures in general and expenditures related to ...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Onabotulinumtoxin-A (BoNT-A) is effective for the treatment of interstitial cystitis/painful bladder syndrome (IC/PBS). However, long-term follow-up does not show successful outcome after a single injection. OBJECTIVES:To evaluate the efficacy and safety of repeated intravesical BoNT-A injections for treatm...
journal_title:Pain physician
pub_type: 临床试验,杂志文章
doi:
更新日期:2013-01-01 00:00:00
abstract::The Department for Health and Human Services (HHS) has issued the final rule that will govern electronic exchanges of financial and administrative information in the health care industry. About 400 different formats currently exist for electronic health care claims. Once compliance with this rule is required (October ...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2000-10-01 00:00:00
abstract::Although percutaneous endoscopic lumbar discectomy (PELD) is an effective treatment for herniated discs, its application in a disc with extensive migration is still challenging. As such, epiduroscopic laser neural decompression (ELND) provides a new view of the epidural space as well as an alternative treatment for a ...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Patients suffering from osteoarthritis of the knee and patients post total knee arthroplasty often develop refractory, disabling chronic knee pain. Radiofrequency ablation, including conventional, pulsed, and cooled, has recently become more accepted as an interventional technique to manage chronic knee pain...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2017-03-01 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:BACKGROUND:Gonadal hormones are critical factors in modulating the experience of pain, as suggested by the several sex differences observed: women have a greater risk of many clinical pain conditions, and postoperative and procedural pain may be more severe in them than in men. A growing body of literature demonstrates...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2012-07-01 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: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::Evidence-based medicine, systematic reviews, and guidelines are part of modern interventional pain management. As in other specialties in the United States, evidence-based medicine appears to motivate the search for answers to numerous questions related to costs and quality of health care as well as access to care. Sc...
journal_title:Pain physician
pub_type: 杂志文章,评审
doi:
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Intradiscal cement leakage (ICL) is a common complication following percutaneous vertebroplasty (PVP). However, the risk factors for such a complication are under debate and there is no accurate predictive nomogram to predict ICL. OBJECTIVES:To establish an effective and novel nomogram for ICL following PVP...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2017-05-01 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:Interventional pain physicians commonly encounter patients with a treatment refractory "chronic pain syndrome". Such patients have a chronically painful medical disorder that is complicated by a number of psychosocial factors, including psychiatric and substance use disorders, physical deconditioning, depend...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2005-10-01 00:00:00
abstract:INTRODUCTION:Postdural puncture headache (PDPH) is a known complication of diagnostic lumbar puncture. Multiple factors including needle size, type, and needle bevel orientation, have been postulated to contribute to the development of PDPH. The presentation of PDPH tends to have classic symptoms that include a postura...
journal_title:Pain physician
pub_type: 杂志文章
doi:
更新日期:2010-05-01 00:00:00