Tajima Keiko, Kawagoe Izumi, Kanai Masanori, Mitsuhata Hiromasa
Department of Anesthesiology and Pain Medicine, Juntendo Tokyo Koto Geriatric Medical Center Tokyo 136-5632.
Masui. 2008 Jul;57(7):874-8.
The incidence of herpes zoster increases with age. Immediate pain relief is required for prevention of postherpetic neuralgia (PHN) and also its related symptoms that worsen the general condition because acute herpetic pain often interferes with sleep, mood, and general activities in elderly patients. Nerve block is useful to relief acute pain and recommended for prevention of PHN. Tricyclic antidepressant drugs have antinoticeptive effect in acute pain in experimental models, in addition to its antidepressant effect.
Forty elderly patients with herpes zoster within 3 months after the onset underwent nerve blocks and received tricyclic antidepressant drugs. We assessed the effect of treatments and adverse effects.
No significant adverse effects were found in elderly patients who had received nerve blocks and/or tricyclic antidepressant drugs. Alleviation of acute pain was obtained in more than 80% of patients, and in all patients depressive state and/or disturbance of the general condition were significantly improved.
With careful technique and assessment of patients, both nerve block and tricyclic antidepressant drugs were beneficial and safe treatments in elderly patients with herpes zoster.
带状疱疹的发病率随年龄增长而增加。预防带状疱疹后神经痛（PHN）及其相关症状需要立即缓解疼痛，因为急性疱疹性疼痛常常会干扰老年患者的睡眠、情绪和日常活动，进而使全身状况恶化。神经阻滞有助于缓解急性疼痛，推荐用于预防PHN。三环类抗抑郁药除了具有抗抑郁作用外，在实验模型中对急性疼痛也有抗伤害感受作用。
40例发病3个月内的老年带状疱疹患者接受了神经阻滞并服用三环类抗抑郁药。我们评估了治疗效果和不良反应。
接受神经阻滞和/或三环类抗抑郁药治疗的老年患者未发现明显不良反应。超过80%的患者急性疼痛得到缓解，所有患者的抑郁状态和/或全身状况紊乱均有显著改善。
通过谨慎的技术操作和患者评估，神经阻滞和三环类抗抑郁药对老年带状疱疹患者都是有益且安全的治疗方法。
