Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Korea.
Korean J Pain. 2013 Jan;26(1):21-6. doi: 10.3344/kjp.2013.26.1.21. Epub 2013 Jan 4.
Postherpetic neuralgia (PHN) is a serious complication resulting from herpes zoster infections, and it can impair the quality of life. In order to relieve pain from PHN, various treatments, including pharmacological and interventional methods have been used. However, little information on the recommendations for the interventional treatment of PHN, along with a lack of nation-wide surveys on the current status of PHN treatment exists. This multicenter study is the first survey on the treatment status of PHN in Korea.
Retrospective chart reviews were conducted on the entire patients who visited the pain clinics of 11 teaching hospitals from January to December of 2011. Co-morbid disease, affected site of PHN, routes to pain clinic visits, parenteral/topical medications for treatment, drugs used for nerve block, types and frequency of nerve blocks were investigated.
A total of 1,414 patients' medical records were reviewed. The most commonly affected site was the thoracic area. The anticonvulsants and interlaminar epidural blocks were the most frequently used pharmacological and interventional methods for PHN treatment. For the interval of epidural block, intervals of 5 or more-weeks were the most popular. The proportion of PHN patients who get information from the mass media or the internet was only 0.8%.The incidence of suspected zoster sine herpete was only 0.1%.
The treatment methods for PHN vary among hospitals. The establishment of treatment recommendation for PHN treatment is necessary. In addition, public relations activities are required in order to inform the patients of PHN treatments by pain clinicians.
带状疱疹后神经痛(PHN)是由带状疱疹感染引起的严重并发症,会降低生活质量。为缓解 PHN 疼痛,已尝试了多种治疗方法,包括药物和介入治疗。然而,目前缺乏关于 PHN 介入治疗推荐的信息,也没有全国性的 PHN 治疗现状调查。本多中心研究是韩国首次针对 PHN 治疗状况的调查。
对 2011 年 1 月至 12 月期间 11 所教学医院疼痛门诊就诊的所有患者进行回顾性病历审查。调查了合并症、PHN 受累部位、就诊途径、治疗用的药物、神经阻滞用药物、神经阻滞类型和频率。
共回顾了 1414 例患者的病历。最常见的受累部位是胸区。抗惊厥药和椎板间硬膜外阻滞是治疗 PHN 最常用的药物和介入方法。硬膜外阻滞的间隔时间,5 周以上的比例最高。仅 0.8%的 PHN 患者从大众媒体或互联网获取信息。疑似无疹性带状疱疹的发生率仅为 0.1%。
各医院的 PHN 治疗方法存在差异。有必要制定 PHN 治疗推荐。此外,需要开展宣传活动,由疼痛科医生向 PHN 患者告知相关治疗信息。