Nishiyama Tomoki, Matsukawa Takashi, Yamashita Koichi
Department of Anesthesiology, The University of Tokyo, Tokyo, Japan.
J Anesth. 2006;20(3):240-2. doi: 10.1007/s00540-006-0399-4.
Neurotropin, a nonproteinaceous extract from the inflamed skin of rabbits inoculated with vaccinia virus, is reported to decrease pain effectively when used for stellate ganglion (SG) injection. We compared the effects of neurotropin SG injection with those of mepivacaine on pain relief, as well as comparing the side effects. One hundred and eighty-eight SG injections in 15 patients (5 with postherpetic neuralgia and 10 with sudden deafness) were performed either with 1% mepivacaine 6 ml or with neurotropin 3 ml combined with saline 3 ml in turn. Fifteen min before and after the injection, the pain score, according to a visual analog scale (VAS; only in patients with postherpetic neuralgia); blood pressure; and heart rate were checked, and the number of procedures with Horner's sign was determined. VAS scores decreased significantly with both injections. Horner's sign was observed on the block side in all procedures with the mepivacaine injection, but it was seen in only 48 procedures with the neurotropin injection. Blood pressure and heart rate did not change. In conclusion, the SG injection of neurotropin decreased the VAS score in postherpetic neuralgia to the same extent as mepivacaine. The incidence of Horner's sign was significantly lower with neurotropin than with mepivacaine.
神经妥乐平是一种从接种痘苗病毒的兔子发炎皮肤中提取的非蛋白质提取物，据报道，用于星状神经节（SG）注射时可有效减轻疼痛。我们比较了神经妥乐平SG注射与甲哌卡因在缓解疼痛方面的效果，以及比较了它们的副作用。对15例患者（5例带状疱疹后神经痛患者和10例突发性耳聋患者）进行了188次SG注射，依次使用6 ml 1%甲哌卡因或3 ml神经妥乐平加3 ml生理盐水。在注射前15分钟和注射后，检查疼痛评分（根据视觉模拟量表（VAS）；仅针对带状疱疹后神经痛患者）、血压和心率，并确定出现霍纳氏征的操作次数。两种注射方式后VAS评分均显著降低。在所有甲哌卡因注射操作中，阻滞侧均观察到霍纳氏征，但在神经妥乐平注射操作中仅48次观察到。血压和心率未发生变化。总之，神经妥乐平SG注射在带状疱疹后神经痛中降低VAS评分的程度与甲哌卡因相同。神经妥乐平引起霍纳氏征的发生率明显低于甲哌卡因。
