Preprint Article Version 1 This version is not peer-reviewed

Therapeutic Effects of Continuous Epidural Infusion of Local Anesthetics with Dexamethasone for Postherpetic Neuralgia

Version 1 : Received: 6 March 2020 / Approved: 7 March 2020 / Online: 7 March 2020 (03:22:47 CET)

How to cite: Choi, E.M.; Chung, M.H.; Jun, J.; Chun, E.H.; Jun, I.; Park, J.H.; Choi, E.; Kim, J.E. Therapeutic Effects of Continuous Epidural Infusion of Local Anesthetics with Dexamethasone for Postherpetic Neuralgia. Preprints 2020, 2020030116 (doi: 10.20944/preprints202003.0116.v1). Choi, E.M.; Chung, M.H.; Jun, J.; Chun, E.H.; Jun, I.; Park, J.H.; Choi, E.; Kim, J.E. Therapeutic Effects of Continuous Epidural Infusion of Local Anesthetics with Dexamethasone for Postherpetic Neuralgia. Preprints 2020, 2020030116 (doi: 10.20944/preprints202003.0116.v1).

Abstract

The most common complication of herpes zoster is postherpetic neuralgia (PHN), which is accompanied by severe pain that lowers patients’ quality of life. Although epidural injection of local anesthetics and steroids is effective in controlling neuropathic pain resulting from herpes zoster, few studies report the efficacy and safety of epidural steroid administration in PHN patients. We randomly assigned 42 patients with severe PHN pain (visual analog scale (VAS) score ≥7) to receive continuous epidural infusion of local anesthetics with either a one-time bolus of 5 mg dexamethasone or dexamethasone pulse therapy. VAS scores significantly decreased over time for all patients, but the reduction in VAS scores and likelihood of achieving complete remission were significantly greater among patients who received dexamethasone pulse therapy, without any adverse effects. These results show that continuous epidural infusion of local anesthetics with dexamethasone is effective and safe for reducing PHN pain and promoting complete remission and that more pronounced beneficial effects are associated with more intense epidural steroid administration.

Subject Areas

continuous epidural infusion; dexamethasone; dexamethasone pulse therapy; inflammation; local anesthetics; neuropathic pain; postherpetic neuralgia

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