Nagai Shuhei, Arai Young-Chang P, Owari Keikoi, Nishihara Makoto, Saisu Hironori, Niwa Hidemi, Terajima Yuki, Igari Hiroki, Ushida Takahiro
Multidisciplinary Pain Center, Aichi Medical University, Nagakute, JPN.
Cureus. 2025 Mar 6;17(3):e80125. doi: 10.7759/cureus.80125. eCollection 2025 Mar.
Herpes zoster is a common disease encountered in clinical practice. The neuropathic pain caused by herpes zoster can be severe enough to interfere with daily life in challenging cases. Although it is said that intervening as early as possible after the onset of the disease improves outcomes, there are some cases that are difficult to treat as immediate interventional therapy is not possible. While there are some reports on the efficacy of intravenous magnesium and lidocaine, we investigated the efficacy of intravenous magnesium and lidocaine in patients with herpes zoster neuritis and postherpetic neuralgia. Patient criteria: A total of 23 patients with herpes zoster neuritis and postherpetic neuralgia were included in the study. We included only cases in which immediate interventional therapy was not possible.
The treatment protocol was an intravenous infusion of a combination of 1.2 g of magnesium and 100 mg of lidocaine for one hour every week for four weeks (five times in total). Patients were assessed using the Numerical Rating Scale (NRS) for pain before and after the treatment at week zero and before the treatment at weeks one, two, three, and four.
There was a statistically significant difference between the median NRS before treatment at week zero and the median NRS before treatment at week one. Similarly, there was a statistically significant difference between the median NRS before treatment at week zero and the median NRS before treatment at weeks two, three, and four. In addition, the NRS tended to decrease as the number of treatments increased.
Intravenous lidocaine and magnesium may be effective for herpes zoster neuritis and postherpetic neuralgia. It may be a treatment method for when immediate interventional therapy is not possible.
带状疱疹是临床实践中常见的疾病。在具有挑战性的病例中，带状疱疹引起的神经性疼痛可能严重到足以干扰日常生活。尽管据说在疾病发作后尽早干预可改善预后，但仍有一些病例因无法立即进行介入治疗而难以处理。虽然有一些关于静脉注射镁和利多卡因疗效的报道，但我们研究了静脉注射镁和利多卡因对带状疱疹神经炎和带状疱疹后神经痛患者的疗效。患者标准：本研究共纳入23例带状疱疹神经炎和带状疱疹后神经痛患者。我们仅纳入无法立即进行介入治疗的病例。
治疗方案为每周静脉输注1.2 g镁和100 mg利多卡因的组合，持续1小时，共四周（总共五次）。在第零周治疗前后以及第一、二、三、四周治疗前，使用数字评分量表（NRS）对患者的疼痛进行评估。
第零周治疗前的NRS中位数与第一周治疗前的NRS中位数之间存在统计学显著差异。同样，第零周治疗前的NRS中位数与第二、三、四周治疗前的NRS中位数之间也存在统计学显著差异。此外，随着治疗次数的增加，NRS有下降趋势。
静脉注射利多卡因和镁可能对带状疱疹神经炎和带状疱疹后神经痛有效。它可能是一种在无法立即进行介入治疗时的治疗方法。
