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Original Article

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Korean J Pain 2019; 32(3): 215-222

Published online July 1, 2019 https://doi.org/10.3344/kjp.2019.32.3.215

Copyright © The Korean Pain Society.

The efficacy of selective nerve root block for the long-term outcome of postherpetic neuralgia

A Ram Doo1,2 , Jin-Wook Choi1 , Ju-Hyung Lee3 , Ye Sull Kim1 , Min-Jong Ki1 , Young Jin Han1,2 , Ji-Seon Son1,2

1Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School, Jeonju, Korea
2Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea
3Department of Preventive Medicine, Chonbuk National University Medical School, Jeonju, Korea

Correspondence to:Ji-Seon Son
Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Korea
Tel: +82-63-250-1241, Fax: +82-63-250-1240, E-mail: sjs6803@jbnu.ac.kr
ORCID: https://orcid.org/0000-0002-6672-4576

Received: April 17, 2019; Revised: June 4, 2019; Accepted: June 10, 2019

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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Background

Several nerve blocks can reduce the incidence of postherpetic neuralgia (PHN) as well as relieve acute zoster-related pain, but the long-term outcome of PHN has not been clearly determined. This study investigated the efficacy of selective nerve root block (SNRB) for herpes zoster (HZ) on the long-term outcome of PHN.

Methods

We prospectively conducted an interview of patients who had undergone an SNRB for HZ from January 2006 to December 2016 to evaluate their long-term PHN status. The relationship between the time from HZ onset to the first SNRB and the long-term outcome of PHN was investigated.

Results

The data of 67 patients were collected. The patients were allocated to acute (SNRB ≤ 14 days, n = 16) or subacute (SNRB > 14 days, n = 51) groups. The proportions of cured patients were 62.5% and 25.5% in the acute and subacute groups (P = 0.007), respectively. In logistic regression, an SNRB >14 days was the significant predictor of PHN (adjusted odd ratio, 3.89; 95% confidence interval, 1.02–14.93; P = 0.047). Kaplan–Meier analysis revealed that time from the SNRB to the cure of PHN was significantly shorter in the acute group (2.4 ± 0.7 yr) than in the subacute group (5.0 ± 0.4 yr; P = 0.003).

Conclusions

An early SNRB during the acute stage of HZ (within 14 days) appears to decrease the incidence and shorten the duration of PHN, with a median of 5.0 years of follow-up.

Keywords: Follow-Up Studies, Ganglia, Spinal, Herpes Zoster, Incidence, Logistic Models, Nerve Block, Neuralgia, Postherpetic, Pain

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