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pISSN 2005-9159
eISSN 2093-0569
eISSN 2093-0569
Korean J Pain 2021; 34(2): 210-216
Published online April 1, 2021 https://doi.org/10.3344/kjp.2021.34.2.210
Copyright © The Korean Pain Society.
Ying Huang1 
, Chenjie Xu2 , Tao Zeng3 , Zhongming Li4 , Yanzhi Xia5 , Gaojian Tao1 , Tong Zhu1 , Lijuan Lu1 , Jing Li1 , Taiyuan Huang1 , Hongbo Huai1 , Benxiang Ning1 , Chao Ma1 , Xinxing Wang6 , Yuhua Chang7 , Peng Mao6 , Jian Lin1
1Department of Pain, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
2Department of Anesthesiology and Pain, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
3Department of Pain, Kunshan Hospital of Integrated Traditional Chinese and Western Medicine, Kunshan, Jiangsu, China
4Department of Pain, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
5Department of Anesthesiology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
6Department of Pain Medicine, China-Japan Friendship Hospital, Beijing, China
7Department of Pain, Bayingolin Mongolian Autonomous Prefecture People’s Hospital, Xinjiang, China
Correspondence to:Jian Lin
Department of Pain, Drum Tower Hospital, Medical School of Nanjing University, 321 Zhongshan Road, Nanjing, Jiangsu 210008, China
Tel: +8625-83106666, Fax: +8625-83106666
E-mail: linjian419@njglyy.com
Peng Mao
Department of Pain Medicine, China-Japan Friendship Hospital, 2 Yinghuayuan East Street, Beijing 100029, China
Tel: +8610-84205288, Fax: +8610-84205288
E-mail: doctormaopeng@126.com
Yuhua Chang
Department of Pain, Bayingolin Mongolian Autonomous Prefecture People’s Hospital, 56 Renmin East Road, Korla, Xinjiang 841000, China
Tel: +86996-2021856, Fax: +86996-2021856
E-mail: 1491955033@qq.com
Handling Editor: Young-Bok Lee
*These authors contributed equally to this work.
Received: October 20, 2020; Revised: December 13, 2020; Accepted: December 28, 2020
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.
Background: Postherpetic neuralgia (PHN) is the most common complication of acute herpes zoster. The treatment of PHN remains a challenge for clinical pain management. Despite the effectiveness of anticonvulsants, antidepressants, and lidocaine patches in reducing PHN, many patients still face intractable pain disorders. In this randomized controlled study, we evaluated whether hydromorphone through intravenous patient-controlled analgesia (IV PCA) was effective in relieving PHN.
Methods: Patients with PHN were randomly divided into two groups, one group received oral pregabalin with IV normal saline, another group received oral pregabalin with additional IV PCA hydromorphone for two weeks. Efficacy was evaluated at 1, 4, and 12 weeks after the end of the treatments.
Results: Two hundred and one patients were followed up for 12 weeks. After treatment, numerical rating scale (NRS) score of patients in the hydromorphone group was significantly lower than that of the control group, and the difference of NRS scores between the two groups was statistically significant at 4 and 12 weeks after treatment. The frequency of breakthrough pain in the hydromorphone group was significantly lower than that in the control group 1 and 4 weeks after treatment. After treatment, the quality of sleep in the hydromorphone group was significantly improved compared with the control group. The most common adverse reactions in the hydromorphone group were dizziness and nausea, with no significant respiratory depression.
Conclusions: IV PCA hydromorphone combined with oral pregabalin provides superior pain relief in patients with PHN, which is worthy of clinical application and promotion.
Keywords: Analgesia, Patient-Controlled, Analgesics, Opioid, Anticonvulsants, Hydromorphone, Neuralgia, Postherpetic, Opiate Alkaloids, Pain, Intractable, Pain Management, Pregabalin.
