The recently introduced pectoral nerve (Pecs) block is a simple alterative to the conventional thoracic paravertebral block or epidural block for breast surgery. It produces excellent analgesia and can be used to provide balanced anesthesia and as a rescue block in cases where performing a neuraxial blockade is not possible. In the thoracic region, a neuraxial blockade is often used to manage zoster-associated pain. However, this can be challenging for physicians due to the increased risk of hemodynamic instability in the upper thoracic level, and comorbid and contraindicated medical conditions such as coagulopathy. Here, we introduce an ultrasound-guided Pecs block for the management of herpes zoster-associated pain, which could be an effective alternative to other interventional options in the thoracic region.
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Clinical study of short-term spinal cord stimulation for herpes zoster-associated pain.
Eur J Med Res
December 2024
Department of Painology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Background: Zoster-associated neuralgia refers to neuropathic pain from herpes zoster, which can persist as postherpetic neuralgia (PHN). Preventing the progression to chronic PHN is crucial, yet optimal interventions is still not clear.
Objectives: This study evaluates the efficacy of short-term spinal cord stimulation (tSCS) in patients with subacute and chronic PHN.
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Department of Pain Management, West China Hospital/West China Tianfu Hospital, Sichuan University, Chengdu, Sichuan Province, China.
Background: High-voltage (65 V) long-duration pulsed radiofrequency (HL-PRF) is an effective method for managing zoster-associated pain (ZAP), though the limited efficacy of and high recurrence rates associated with the procedure present concerns.
Objectives: This study aimed to investigate the safety and effectiveness of a higher-voltage HL-PRF treatment based on the original procedure for ZAP in the spinal area.
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Department of Pain Medicine, The Second Affiliated Hospital of Guangxi Medical University, Nanning, 530007, Guangxi, China.
Background: Herpes zoster (HZ), triggered by the reactivation of the varicella-zoster virus, manifests as a painful rash known as zoster-associated pain (ZAP), which can progress to postherpetic neuralgia (PHN). This study evaluates the efficacy and safety of ultrasound-guided thoracic paravertebral injections of platelet-rich plasma (PRP) in managing acute ZAP and preventing PHN.
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Non-oral pharmacological interventions in the management of herpes zoster-related pain: a review of current research.
Front Pain Res (Lausanne)
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Clinical Medical College, Hebei University, Baoding, Hebei, China.
Herpes zoster-associated pain is a difficult-to-treat pathologic pain that seriously affects patients' quality of life. In recent years, emerging therapeutic techniques such as autologous platelet-rich plasma, sympathetic nerve block and pulsed radiofrequency have been gradually applied in the field of pain with the advantages of less trauma, quicker recovery and significant efficacy. These therapeutic options have become a new hope for the treatment of herpes zoster-associated pain.
View Article and Find Full Text PDFA central and peripheral dual neuromodulation strategy in pain management of zoster-associated pain.
Sci Rep
October 2024
Department of Pain, The Third Xiangya Hospital, Institute of Pain Medicine, Central South University, Changsha, China.
Article Synopsis
- A study investigates the effectiveness of spinal cord stimulation (SCS) combined with dorsal root ganglion (DRG) pulsed radiofrequency (PRF) in treating zoster-associated pain (ZAP), comparing it to SCS alone.
- Results showed that while VAS scores were similar at the start and discharge, the SCS+PRF group had significantly lower pain scores at a 6-month follow-up and fewer patients experienced residual moderate pain.
- Additionally, no patients in the SCS+PRF group progressed to postherpetic neuralgia, indicating that this combined treatment may be a better option for managing ZAP.
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