Korean J Anesthesiol.  2002 Nov;43(5):594-599. 10.4097/kjae.2002.43.5.594.

Is an Epidural Steroid Injection with an Addition of an Intravenous and Intradermal Injection of Lidocaine Advantageous in the Pain Management of Herpes Zoster?

• Song SO
• Yun JS
• Lee DH

• KMID: 2091730
• DOI: http://doi.org/10.4097/kjae.2002.43.5.594

Abstract

BACKGROUND: An epidural blockade has been considered a standard therapy for the management of pain in acute herpes zoster. However, it has many complications. Recently, we experienced good analgesia with a combination therapy including intravenous lidocaine infusion and intradermal injection of a local anesthetic and steroid in acute herpes zoster. Therefore, this study was performed to evaluate the necessity of an epidural steroid injection, added in a combination therapy, on the pain control of acute herpes zoster.
METHODS
This retrospective study was based on the analysis of data of medical records. Forty-three patients suffering severe acute herpes zoster pain, were randomly divided into two groups. Intravenous lidocaine infusion (5 mg/kg) and an intradermal injection of lidocaine and a steroid into the wound were used twice a week in the Lidocaine group (n = 23), and in the Epidural group (n = 20), an epidural block with 0.5% lidocaine 6-8 ml with triamcinolone 30 mg was added once a week in addition to the above. We compared the efficacy of pain control using a pain relief scale (PRS) at 4 weeks after the initial visit to the pain clinic.
RESULTS
Both groups were similarly managed in pain control. There were no statistical differences comparing the PRS between the two groups.
CONCLUSIONS
Our results suggest that an epidural steroid injection, added in a combination therapy such as an intravenous lidocaine infusion and an intradermal injection of a local anesthetic and steroid, has no more advantages for the management of pain in acute herpes zoster. A further prospective study is recommended to compare the efficacy of pain control and the incidence of postherpetic neuralgia in a large number of acute herpes zoster patients.

Keyword

Epidural steroid injection; herpes zoster; intradermal injection; intravenous lidocaine infusion; pain

MeSH Terms

Analgesia
Herpes Zoster*
Humans
Incidence
Injections, Intradermal*
Lidocaine*
Medical Records
Neuralgia, Postherpetic
Pain Clinics
Pain Management*
Retrospective Studies
Triamcinolone
Wounds and Injuries
Lidocaine
Triamcinolone