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Relief of acute pain in herpes zoster ophthalmicus by stellate ganglion block.

1986; BMJ; Volume: 292; Issue: 6533 Linguagem: Inglês

10.1136/bmj.292.6533.1428

0959-8138

Simon Harding, J R Lipton, J.C.D. Wells, J. A. Campbell,

Healthcare and Venom Research

Relief of acute pain in herpes zoster ophthalmicus by steliate ganglion blockStellate ganglion block has been suggested as a useful treatment for trigeminal herpes zoster,'4 being most effective if started within two weeks of the onset of the disease.'We evaluated the efficacy of this treatment in a randomised prospective controlled study for the first time and assessed its complications. Patients, methods, and resultsThirty patients aged 60 and over who presented with herpes zoster ophthalmicus were recruited and randomly allocated to one oftwo groups: treated (group A; mean age 71-5 (range 60-87) years) or untreated (group B; mean age 72 *2 (62- 92) years).Pain was assessed by visual-analogue scale set horizontally for 100 mm.Patients in group A underwent stellate ganglion block within 14 days of the onset of the rash as previously described.5After verbal consent a 0-5 ml test dose, followed 30 seconds later by a 9-5 ml bolus ofequal parts 1% lignocaine and 0-5% marcaine, was injected on to the C5/C6 prevertebral fascia.Effect was assessed from miosis, hyperthermia, and pain relief at 60 minutes.Patients were followed up for at least three months.In group A mean pain score before block was 41-9 mm; at one hour it was 5-2 mm, a highly significant reduction (p<0001, paired t test).Pain scores in subsequent time bands were compared with those at presentation in patients from each group by paired t tests (table).In group A there was a highly significant Mean visual analogue scale pain scores for patients treated by stellate ganglion block and untreated patients at presentation and at subsequent time bands 2 Weeks-6 Weeks-Presentation I month 2 months 3 Months Treated 42 53 12 43* 31-45t 10-46* Untreated 26-67 16 45t 14 85f 11 71t