Assessment of ultrasound-guided intercostal nerve block for acute herpes zoster and its' possible prophylaxis for postherpetic neuralgia: a retrospective and case-controlled trial
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: This study aimed to compare the intercostal nerve block (ICNB) and thoracic paravertebral block (TPVB) for acute herpes zoster-associated pain (ZAP) and possible prophylaxis for post-herpetic neuralgia (PHN). Methods: This study enrolled 128 patients with ZAP. Their records were stratified into standard antiviral treatment (AVT) plus US-guided TPVB (the TPVB group), AVT plus US-guided ICNB (the ICNB group) or AVT alone (the control group). Herpes zoster (HZ)-related burden of illness (HZ-BOI) within the post-procedural 30 days was defined as the primary endpoint, determined by a composite of pain severity and follow-up duration. Procedure time, rescue analgesic requirement, PHN incidence, health-related quality of life and side effects were also recorded. Results: Significantly lower HZ-BOI-AUC30 was reported in the TPVB and ICNB groups as compared to the control group, with a mean difference of 57.5 (P < 0.001) and 40.3 (P = 0.003), respectively. However, there was no difference between the TPVB and ICNB groups (P = 0.978). Both TPVB and ICNB reported significantly greater improvements in PHN incidence, EQ-5D-3L scores and rescue analgesic requirements during follow-up, as opposed to the control AVT. Shorter procedure time was observed in ICNB as compared to TPVB (16.47 ± 3.39 vs. 11.69 ± 2.58, P < 0.001). Conclusions: Both US-guided TPVBs and ICNBs were effective for ZAP, and accounted for possible prophylaxis for PHN, as compared to AVT alone. The ICNB approach could be recommended as an alternative to conventional TPVB with a better consumed procedure time and side effect profile.
Abstract
Background: This study aimed to compare the intercostal nerve block (ICNB) and thoracic paravertebral block (TPVB) for acute herpes zoster-associated pain (ZAP) and possible prophylaxis for post-herpetic neuralgia (PHN). Methods: This study enrolled 128 patients with ZAP. Their records were stratified into standard antiviral treatment (AVT) plus US-guided TPVB (the TPVB group), AVT plus US-guided ICNB (the ICNB group) or AVT alone (the control group). Herpes zoster (HZ)-related burden of illness (HZ-BOI) within the post-procedural 30 days was defined as the primary endpoint, determined by a composite of pain severity and follow-up duration. Procedure time, rescue analgesic requirement, PHN incidence, health-related quality of life and side effects were also recorded. Results: Significantly lower HZ-BOI-AUC30 was reported in the TPVB and ICNB groups as compared to the control group, with a mean difference of 57.5 (P < 0.001) and 40.3 (P = 0.003), respectively. However, there was no difference between the TPVB and ICNB groups (P = 0.978). Both TPVB and ICNB reported significantly greater improvements in PHN incidence, EQ-5D-3L scores and rescue analgesic requirements during follow-up, as opposed to the control AVT. Shorter procedure time was observed in ICNB as compared to TPVB (16.47 ± 3.39 vs. 11.69 ± 2.58, P < 0.001). Conclusions: Both US-guided TPVBs and ICNBs were effective for ZAP, and accounted for possible prophylaxis for PHN, as compared to AVT alone. The ICNB approach could be recommended as an alternative to conventional TPVB with a better consumed procedure time and side effect profile.
참고문헌 (30)
- Schmader K, "Herpes zoster", Ann Intern Med, pp.ITC19~ITC31 (2018)
- John AR, "Herpes zoster in the older adult", Infect Dis Clin North Am, 31, pp.811~826 (2017)
- Yawn BP, "A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction", Mayo Clin Proc, 82, pp.1341~1349 (2007)
- Nalamachu S, "Diagnosing and managing postherpetic neuralgia", Drugs Aging, 29, pp.863~869 (2012)
- Kumar V, "Neuraxial and sympathetic blocks in herpes zoster and postherpetic neuralgia : an appraisal of current evidence", Reg Anesth Pain Med, 29, pp.454~461 (2004)
- Liu F, "Efficacy of repetitive paravertebral block combined with medication in the treatment of zoster-related pain with different courses", Neurosciences (Riyadh), 26, pp.192~198 (2021)
- Ma Y, "A prospective randomized comparison of the efficacy of standard antiviral therapy versus ultrasound-guided thoracic paravertebral block for acute herpes zoster", Ann Med, 54, pp.369~378 (2022)
- Deng A, "Ultrasoundguided thoracic paravertebral block using paraventricular oblique sagittal(POS)approach for the treatment of acute herpes zoster : a two-blind randomized controlled trial", Pain Ther, 12, pp.797~809 (2023)
- Lopez-Rincon RM, "Ultrasound-guided intercostal nerve block" (2024), StatPearls Publishing
- Lee HJ, "Effect of ultrasound-guided intercostal nerve block versus fluoroscopy-guided epidural nerve block in patients with thoracic herpes zoster : a comparative study", J Ultrasound Med, 38, pp.725~731 (2019)
- von Elm E, "The Strengthening the Reporting of Observational Studies in Epidemiology(STROBE)statement : guidelines for reporting observational studies", Int J Surg, 12, pp.1495~1499 (2014)
- Carlson CL, "Effectiveness of the World Health Organization cancer pain relief guidelines : an integrative review", J Pain Res, 9, pp.515~534 (2016)
- Coplan PM, "Development of a measure of the burden of pain due to herpes zoster and postherpetic neuralgia for prevention trials : adaptation of the brief pain inventory", J Pain, 5, pp.344~356 (2004)
- Callegaro A, "Burden-of-illness vaccine efficacy", Pharm Stat, 19, pp.636~645 (2020)
- Hurst NP, "Measuring health-related quality of life in rheumatoid arthritis : validity, responsiveness and reliability of EuroQol(EQ-5D)", Br J Rheumatol, 36, pp.551~559 (1997)
- Curran D, "Impact of herpes zoster and postherpetic neuralgia on the quality of life of Germans aged 50 or above", BMC Infect Dis, 18, pp.496~ (2018)
- Chen N, "Antiviral treatment for preventing postherpetic neuralgia", Cochrane Database Syst Rev, 2014, pp.CD006866~ (2014)
- Wu CL, "The role of sympathetic nerve blocks in herpes zoster and postherpetic neuralgia", Pain, 87, pp.121~129 (2000)
- Zhou H, "A systematic review and meta-analysis of independent risk factors for postherpetic neuralgia", Ann Palliat Med, 10, pp.12181~12189 (2021)
- Yabuki S, "Nerve root infiltration and sympathetic block. An experimental study of intraradicular blood flow", Spine (Phila Pa 1976), 20, pp.901~906 (1995)
- Devor M, "Corticosteroids suppress ectopic neural discharge originating in experimental neuromas", Pain, 22, pp.127~137 (1985)
- Flower RJ, "Anti-inflammatory steroids induce biosynthesis of a phospholipase A2 inhibitor which prevents prostaglandin generation", Nature, 278, pp.456~459 (1979)
- McGrath JM, "Incidence and characteristics of complications from epidural steroid injections", Pain Med, 12, pp.726~731 (2011)
- Ardon AE, "Paravertebral block : anatomy and relevant safety issues", Korean J Anesthesiol, 73, pp.394~400 (2020)
- Naja Z, "Somatic paravertebral nerve blockade. Incidence of failed block and complications", Anaesthesia, 56, pp.1184~1188 (2001)
- Helen L, "Nerve localization techniques for peripheral nerve block and possible future directions", Acta Anaesthesiol Scand, 59, pp.962~974 (2015)
- Krediet AC, "Different approaches to ultrasound-guided thoracic paravertebral block : an illustrated review", Anesthesiology, 123, pp.459~474 (2015)
- Szamborski M, "Use of ultrasound-guided interfascial plane blocks in anterior and lateral thoracic wall region as safe method for patient anesthesia and analgesia : review of techniques and approaches during COVID-19 pandemic", Int J Environ Res Public Health, 19, pp.8696~ (2022)
- Vlassakov K, "A prospective, randomized comparison of ultrasonographic visualization of proximal intercostal block vs paravertebral block", BMC Anesthesiol, 20, pp.13~ (2020)
- Guerra-Londono CE, "Assessment of intercostal nerve block analgesia for thoracic surgery : a systematic review and metaanalysis", JAMA Netw Open, 4, pp.e2133394~ (2021)