Stellate Ganglion Block for the Treatment of Acute Herpetic Pain Involving the Trigeminal and Cervical Regions

概要

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There are few reports in which severities of skin lesions of herpes zoster itself are considered as a determinant of duration of treatment for acute herpetic pain. Taking into account the severities of skin lesions of herpes zoster, the reason that durations of treatment for acute herpetic pain in the elderly and patients with trigeminal involvement become longer should be regarded due to the higher frequencies of severe skin lesions of herpes zoster in the elderly and trigeminal involvement, rather than due to the factor of aging or trigeminal involvement. Sympathetic nerve blocks can relieve acute herpetic pain promptly; however, an intensive treatment with repeated sympathetic nerve blocks is required to relieve severe acute herpetic pain. There are no apparent differences between stellate ganglion block and high thoracic epidural block in the efficacy of relieving acute herpetic pain in the trigeminal region. Since continuous high thoracic epidural block can be done using an indwelling epidural catheter, continuous high thoracic epidural blocks, rather than intermittent stellate ganglion blocks, should be considered to be the treatment of choice in inpatients with severe acute herpetic pain involving the trigeminal region. Stellate ganglion blocks may be added to continuous high thoracic epidural blocks in some selected patients with trigeminal herpes zoster.
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