Riopelle J, Lopez-Anaya A, Cork R C, Heitler D, Eyrich J, Dunston A, Riopelle A J, Johnson W, Ragan A, Naraghi M
Department of Anesthesiology, Louisiana State University Medical Center, New Orleans.
J Am Acad Dermatol. 1994 May;30(5 Pt 1):757-67. doi: 10.1016/s0190-9622(08)81507-1.
Treatment of the pain of acute herpes zoster by local anesthetic injections has drawbacks. Topical percutaneous local anesthesia (TPLA) may offer another strategy of providing regional analgesia in affected patients.
We evaluate the analgesic efficacy and safety of 9% (wt/vol) lidocaine (base) in petrolatum/paraffin ointment in patients with acute herpes zoster.
Ointment was applied to the affected skin of 22 patients. Pain, tenderness, sensitivity to pinprick and cold, and blood lidocaine concentration were measured repeatedly during a 20-hour interval and intermittently thereafter.
Mean pain, tenderness, and cutaneous sensation scores were reduced at measurements taken from 4 to 20 hours after ointment application (p < 0.05), but not every patient obtained relief. No patient had local skin irritation or systemic toxic effects related to the local anesthetic.
TPLA is a promising therapy for control of cutaneous pain of acute herpes zoster. Controlled studies should be performed to prove efficacy, determine optimal TPLA formulation, and define dosage limits.
通过局部麻醉剂注射治疗急性带状疱疹疼痛存在缺点。局部经皮局部麻醉（TPLA）可能为受影响患者提供另一种区域镇痛策略。
我们评估9%（重量/体积）利多卡因（碱）凡士林/石蜡软膏对急性带状疱疹患者的镇痛效果和安全性。
将软膏涂抹于22例患者的患部皮肤。在20小时间隔内反复测量疼痛、压痛、对针刺和冷刺激的敏感性以及血液利多卡因浓度，此后间歇性测量。
软膏涂抹后4至20小时测量时，平均疼痛、压痛和皮肤感觉评分降低（p<0.05），但并非每位患者都获得缓解。没有患者出现与局部麻醉剂相关的局部皮肤刺激或全身毒性作用。
TPLA是控制急性带状疱疹皮肤疼痛的一种有前景的治疗方法。应进行对照研究以证明疗效、确定最佳TPLA配方并确定剂量限制。
