Psoas compartment block for treatment of motor weakness and pain following herpes zoster
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Reactivation of the latent varicella zoster virus in the sensory ganglion causes herpes zoster (HZ). Its characteristic symptom is a painful rash in the involved dermatome. HZ-induced motor weakness is rare and is usually resolved within one year of the onset, but some patients permanently experience motor dysfunction. Epidural steroid administration, with antiviral therapy, can be effective in treating pain from HZ and preventing postherpetic neuralgia. But an epidural block is contraindicated in patients receiving thromboprophylaxis. A psoas compartment block (PCB) provides equivalent analgesic efficacy with significantly low incidence of complication, compared to an epidural block. A 68 year old male patient recieving thromboprophylaxis presented with motor weakness following painful rash in his left L4 dermatome. Ten days before presentation, herpetic rash occurred on his left leg. We performed PCB with a steroid and local anesthetic, which successfully and safely alleviated the pain and motor weakness from HZ. (Korean J Pain 2017; 30: 62-5)
Abstract
Reactivation of the latent varicella zoster virus in the sensory ganglion causes herpes zoster (HZ). Its characteristic symptom is a painful rash in the involved dermatome. HZ-induced motor weakness is rare and is usually resolved within one year of the onset, but some patients permanently experience motor dysfunction. Epidural steroid administration, with antiviral therapy, can be effective in treating pain from HZ and preventing postherpetic neuralgia. But an epidural block is contraindicated in patients receiving thromboprophylaxis. A psoas compartment block (PCB) provides equivalent analgesic efficacy with significantly low incidence of complication, compared to an epidural block. A 68 year old male patient recieving thromboprophylaxis presented with motor weakness following painful rash in his left L4 dermatome. Ten days before presentation, herpetic rash occurred on his left leg. We performed PCB with a steroid and local anesthetic, which successfully and safely alleviated the pain and motor weakness from HZ. (Korean J Pain 2017; 30: 62-5)
참고문헌 (17)
- Young Hoon Jeon, "Herpes Zoster and Postherpetic Neuralgia: Practical Consideration for Prevention and Treatment", The Korean Journal of Pain, 28(3), pp.177~184 (2015), 대한통증학회
- 이미현, "Newly Developed Urinary Retention and Motor Weakness of Lower Extremities in a Postherpetic Neuralgia Patient", The Korean Journal of Pain, 26(1), pp.76~79 (2013), 대한통증학회
- Chernev I, "Segmental zoster abdominal paresis (zoster pseudohernia): a review of the literature", PM R, 5, pp.786~790 (2013)
- Kim JG, "Herpetic brachial plexopathy: application of brachial plexus magnetic resonance imaging and ultrasound-guided corticosteroid injection", Am J Phys Med Rehabil, 95, pp.e67~e71 (2016)
- 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)
- Vandermeulen EP, "Anticoagulants and spinal-epidural anesthesia", Anesth Analg, 79, pp.1165~1177 (1994)
- Moen V, "Severe neurological complications after central neuraxial blockades in Sweden 1990-1999", Anesthesiology, 101, pp.950~959 (2004)
- Türker G, "Comparison of the catheter-technique psoas compartment block and the epidural block for analgesia in partial hip replacement surgery", Acta Anaesthesiol Scand, 47, pp.30~36 (2003)
- Florence JM, "Intrarater reliability of manual muscle test(Medical Research Council scale)grades in Duchenne's muscular dystrophy", Phys Ther, 72, pp.115~122 (1992)
- Jones LK Jr, "Clinical, electrophysiologic, and imaging features of zoster-associated limb paresis", Muscle Nerve, 50, pp.177~185 (2014)
- Mondelli M, "Herpes zoster of the head and limbs: electroneuromyographic and clinical findings in 158 consecutive cases", Arch Phys Med Rehabil, 83, pp.1215~1221 (2002)
- Conliffe TD, "Herpes zoster radiculopathy treated with fluoroscopically-guided selective nerve root injection", Pain Physician, 12, pp.851~853 (2009)
- Horlocker TT, "Regional anesthesia in the anticoagulated patient : defining the risks(the second ASRA Consensus Conference on Neuraxial Anesthesia and Anticoagulation)", Reg Anesth Pain Med, 28, pp.172~197 (2003)
- Kim S, "Treatment of abdominal segmental hernia, constipation, and pain following herpes zoster with paravertebral block", Pain Physician, 18, pp.E927~E929 (2015)
- Parkinson SK, "Extent of blockade with various approaches to the lumbar plexus", Anesth Analg, 68, pp.243~248 (1989)
- Chelly JE, "Consensus of the Orthopedic Anesthesia, Pain, and Rehabilitation Society on the use of peripheral nerve blocks in patients receiving thromboprophylaxis", J Clin Anesth, 26, pp.69~74 (2014)
- Hardy D, "Relief of pain in acute herpes zoster by nerve blocks and possible prevention of post-herpetic neuralgia", Can J Anaesth, 52, pp.186~190 (2005)