Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Seoul, South Korea.
Pain Physician. 2012 Jan-Feb;15(1):E107-13.
Effective early antiviral treatments reduce both acute zoster pain and the risk of postherpetic neuralgia. The authors hypothesized that the direct neuraxial administration of acyclovir could provide superior drug application to the spinal neural structures with a higher viral burden and have various advantages over the other routes of drug administration in terms of required doses, side effects, and efficacy.
To know whether intrathecal acyclovir injection is neurologically and histopathologically safe or not.
Randomized, experimental trial in rats.
Associated experiment center.
A total of 40 rats weighing between 250-300g were used. The rats were randomly divided into 2 groups of 20 each using a random number table: normal saline group (Group N) and acyclovir group (Group A). Rats in Group N were administered 20 μl of normal saline and Group A were administered the same volume of 700 μg/mL acyclovir into the intrathecal space via an intrathecal catheter. Saline or acyclovir was administered daily for 5 consecutive days. The changes in behavior and sensory-motor function were checked and histopathological findings of the spinal cords were observed by light and electron microscopy.
No rats in Group N or Group A showed any behavioral change or sensory-motor dysfunction during the 5-day observation period. Furthermore, no histopathological abnormalities of the spinal cord were observed in the 6th day after the last intrathecal administration of the drug.
There is a need to perform studies to evaluate long-term safety by observing cumulative neurotoxic effects with continual injection during a long-term period.
There was no evidence of neurological and histopathological abnormalities following intrathecal acyclovir injection.
有效的早期抗病毒治疗可减轻带状疱疹急性期疼痛和疱疹后神经痛的风险。作者假设阿昔洛韦直接椎管内给药可以为病毒负荷更高的脊髓神经结构提供更好的药物应用，并在所需剂量、副作用和疗效方面优于其他给药途径。
了解鞘内阿昔洛韦注射是否在神经病理学上安全。
大鼠随机、实验性试验。
相关实验中心。
使用体重 250-300g 的大鼠共 40 只，采用随机数字表法将其随机分为生理盐水组（N 组）和阿昔洛韦组（A 组），每组 20 只。N 组鞘内注射 20μl 生理盐水，A 组鞘内注射相同体积的 700μg/ml 阿昔洛韦。每日鞘内给药，连续 5 天。通过观察行为和感觉运动功能的变化以及光镜和电镜下观察脊髓的组织病理学发现来评估鞘内注射阿昔洛韦的安全性。
在 5 天的观察期间，N 组和 A 组的大鼠均未出现任何行为改变或感觉运动功能障碍。此外，在最后一次鞘内给药后第 6 天，脊髓也未观察到组织病理学异常。
需要通过长期连续注射观察累积神经毒性作用来评估长期安全性的研究。
鞘内阿昔洛韦注射后无神经病理学异常。
