Korean J Anesthesiol.  2013 Nov;65(5):462-467. 10.4097/kjae.2013.65.5.462.

Epidural catheterization with a subcutaneous injection port for the long-term administration of opioids and local anesthetics to treat zoster-associated pain: a report of two cases

• Min BM
• Kim JH

• KMID: 2299421
• DOI: http://doi.org/10.4097/kjae.2013.65.5.462

Abstract

Continuous epidural analgesia has been used for decades to treat acute herpes zoster pain and to prevent postherpetic neuralgia. However, many technical problems can arise during chronic treatment with epidural medications. These complications include catheter dislodgement, infection, injection pain, leakage, and occlusion. Epidural catheter placement utilizing subcutaneous injection port implantation has gained widespread acceptance as a method to overcome such complications. The technique reduces the risk of infection, the most feared complication, compared to the use of a percutaneous epidural catheter. Herein, we present 2 cases in which the continuous thoracic epidural administration of opioids and local anesthetics through an implantable subcutaneous injection port for over 2 months successfully treated zoster-associated pain without any technique- or medication-related complications in patients with risk factors for epidural abscess.

Keyword

Epidural injections; Herpes zoster; Local anesthetics; Opioid analgesics

MeSH Terms

Analgesia, Epidural
Analgesics, Opioid*
Anesthetics, Local*
Catheterization*
Catheters*
Epidural Abscess
Herpes Zoster
Humans
Injections, Epidural
Injections, Subcutaneous*
Neuralgia, Postherpetic
Risk Factors
Analgesics, Opioid
Anesthetics, Local