J Korean Pain Soc.  2004 Dec;17(2):262-265. 10.3344/jkps.2004.17.2.262.

Severe Lower Extremity Edema during the Post-herpetic Neuralgia Management in Old Age: A case report

• Jo DH
• Lee SJ
• Kim JJ
• Kim MH

• KMID: 2104868
• DOI: http://doi.org/10.3344/jkps.2004.17.2.262

Abstract

Herpes zoster (HZ), or shingles, is a common disease. For most patients skin healing and pain resolution occur within 3 4 weeks. However, pain can continue after the rash has healed. Herein, a case is presented in which acute urinary retention (AUR) occurred during post-herpetic neuralgia (PHN) treatment in an old aged patient. The patient was an 84-year-old man, who was evaluated due to reports of excruciating and burning pain secondary to HZ on the left thigh and knee area of 2 months duration. Initially, the symptoms of PHN were likely to respond well to the conventional combination of sympathetic blockade, anticonvulsants, antidepressants and opioids. However, after the administration of a mixed intravenous infusion of ketamine and midazolam, the patient experienced a sudden onset of AUR, with severe edema of both legs, which lasted 72 hours. Upon insertion of a Nelaton catheter, approximately 900 ml of clear, yellow urine were obtained, which resulted in a marked improvement of his discomfort. This case of acute transient urinary retention, associated with PHN management in old age, is reported.

Keyword

acute urinary retention; ketamine; post-herpetic neuralgia

MeSH Terms

Aged, 80 and over
Analgesics, Opioid
Anticonvulsants
Antidepressive Agents
Burns
Catheters
Edema*
Exanthema
Herpes Zoster
Humans
Infusions, Intravenous
Ketamine
Knee
Leg
Lower Extremity*
Midazolam
Neuralgia*
Skin
Thigh
Urinary Retention
Analgesics, Opioid
Anticonvulsants
Antidepressive Agents
Ketamine
Midazolam