Clinical Study of Intradermal Block Treatment for Post-herpetic Neuralgia Using Different Dose of Compound Betamethasone_West China Medical Journal

Authors：

 FanWenjiang ¹ ,  LiuQing ²

1. Department of Pain Medicine, the First People’s Hospital of Neijiang, Neijiang, Sichuan 641000, P. R. China;
2. Department of Pain Medicine, the Affiliated Chinese Medical Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P. R. China;

Corresponding?author：

LiuQing, Email: 1105859368@qq.com

Keywords：

Post-herpetic neuralgia; Intradermal block; Compound betamethasone; Visual analogue scale; Quality of sleep

DOI：

10.7507/1002-0179.201600191

Video：

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Objective To compare the effect of different doses of compound betamethasone intradermal block on post-herpetic neuralgia (PHN) in elderly patients. Methods Between June 2013 and December 2014, 96 elderly patients who matched the criteria of PHN were chosen and randomly divided into saline control group (group C), compound betamethasone 0.5 mL group (group B_0.5) and compound betamethasone 1.0 mL group (group B_1.0). For the control group, 20 mL analgesic saline liquid including 5 mL of 2% lidocaine was used. And 0.5 and 1.0 mL compound betamethasone was added into the solution of group C to get the solution for group B_0.5 and group B_1.0, respectively. The patients got intracutaneous injection once in the affected area on the day 1, 8, and 15 respectively, and patients in the same group were injected the same solution of analgesic liquid. All the patients took the same medicine during treatment. Their visual analog scale (VAS) scores, quality of sleep (QS) scores and adverse events before treatment (T₀), at discharging from the hospital (T₁), and three months after discharging (T₂) were carefully noted and analyzed. Results The VAS and QS scores of the three groups at T1 and T2 improved significantly compared with those at T0 (P < 0.05). The VAS and QS scores of group B_0.5 and group B_1.0 improved significantly more compared with group C (P < 0.05), and the difference of VAS and QS scores between group B_0.5 and group B_1.0 was not statistically insignificant (P > 0.05). Conclusions Adding 0.5 mL or 1 mL of compound betamethasone to the 20 mL analgesic liquid for intradermal block treatment on PHN can obviously release patients’ pain and improve their sleep quality. Compared with 1 mL, adding 0.5 mL compound betamethasone to the 20 mL analgesic liquid for intradermal block treatment on PHN is a more ideal dose.

Citation： FanWenjiang, LiuQing. Clinical Study of Intradermal Block Treatment for Post-herpetic Neuralgia Using Different Dose of Compound Betamethasone. West China Medical Journal, 2016, 31(4): 700-703. doi: 10.7507/1002-0179.201600191 Copy

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9.	劉太華, 王駿, 王春梅. 不同方案治療帶狀皰疹神經痛療效比較[J]. 華西醫學, 2015, 30(7): 1243-1245.
10.	王文珠, 王冉, 劉建, 等. 背根神經節脈沖射頻刺激聯合普瑞巴林治療帶狀皰疹后遺神經痛的臨床療效[J]. 臨床麻醉學雜志, 2014, 30(7): 663-665.
11.	陳彥青, 林瑩, 戴雙波. 改良椎旁神經阻滯治療帶狀皰疹后遺神經痛[J]. 中國疼痛醫學雜志, 2010, 16(1): 54-56.
12.	邵大清. 復方倍他米松不同給藥途徑對軀干皰疹后神經痛的效能評估[J]. 浙江實用醫學, 2010, 15(3): 178-180.
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14.	章云海, 曾因明. 皮內注射治療帶狀皰疹后神經痛的機制[J]. 中華麻醉學雜志, 2003, 23(2): 115-117.
15.	王雪笠, 馮連元, 賀銀芳, 等. 伴有抑郁或焦慮癥狀的慢性失眠癥患者多導睡眠圖分析[J]. 中國行為醫學科學, 2005, 14(3): 246.
16.	王淑萍, 王靜. 側隱窩聯合皮內給予復方倍他米松對老年人腰骶段帶狀皰疹后神經痛的療效[J]. 鄭州大學學報: 醫學版, 2014, 49(2): 281-283, 284.
17.	Kost RG, Straus SE. Postherpetic neuralgia-pathogenesis, treatment, and prevention[J]. N Engl J Med, 1996, 335(1): 32-42.

1. ?Neogi M, Basak S, Ghosh D, et al. A randomized double-blind placebo-controlled clinical study on the effects of gabapentin premedication on hemodynamic stability during laparoscopic cholecystectomy[J]. J Anaesthesiol Clin Pharmacol, 2012, 28(4): 456-459.
2. Johnson RW, Mcelhaney J. Postherpetic neuralgia in the elderly[J]. Int J Clin Pract, 2009, 63(9): 1386-1391.
3. Deniz MN, Sertoz N, Erhan E, et al. Effects of preoperative gabapentin on postoperative pain after radical retropubic prostatectomy[J]. J Int Med Res, 2012, 40(6): 2362-2369.
4. 魄偉, 吳惠俐, 秦立模. 三種糖皮質激素治療帶狀皰疹神經痛的經濟學評價[J]. 復旦學報: 醫學版, 2004, 31(1): 78.
5. 慶俊. 應用糖皮質激素治療帶狀皰疹神經痛的臨床療效[J]. 現代預防醫學, 2011, 38(21): 4517-4518.
6. 王淑萍, 王靜. 側隱窩聯合皮內給予復方倍他米松對老年人腰骶段帶狀皰疹后神經痛的療效[J]. 鄭州大學學報: 醫學版, 2014, 49(2): 281-284.
7. 帶狀皰疹后神經痛診療共識編寫專家組. 帶狀皰疹后神經痛診療中國專家共識(2016)[J]. 中國疼痛醫學雜志, 2016, 22(3): 161-167.
8. 王家雙, 陳軍. 老年人頑固性皰疹后神經痛臨床規范化診療[J]. 中華老年醫學雜志, 2014, 33(8): 845-848.
9. 劉太華, 王駿, 王春梅. 不同方案治療帶狀皰疹神經痛療效比較[J]. 華西醫學, 2015, 30(7): 1243-1245.
10. 王文珠, 王冉, 劉建, 等. 背根神經節脈沖射頻刺激聯合普瑞巴林治療帶狀皰疹后遺神經痛的臨床療效[J]. 臨床麻醉學雜志, 2014, 30(7): 663-665.
11. 陳彥青, 林瑩, 戴雙波. 改良椎旁神經阻滯治療帶狀皰疹后遺神經痛[J]. 中國疼痛醫學雜志, 2010, 16(1): 54-56.
12. 邵大清. 復方倍他米松不同給藥途徑對軀干皰疹后神經痛的效能評估[J]. 浙江實用醫學, 2010, 15(3): 178-180.
13. Amjad M, Mashhood AA. The efficacy of local infiltration of triamcinolone acetonide with lignocaine compared with lignocaine alone in the treatment of postherpetic neuralgia[J]. J Coll Physicians Surg Pak, 2005, 15(11): 683-685.
14. 章云海, 曾因明. 皮內注射治療帶狀皰疹后神經痛的機制[J]. 中華麻醉學雜志, 2003, 23(2): 115-117.
15. 王雪笠, 馮連元, 賀銀芳, 等. 伴有抑郁或焦慮癥狀的慢性失眠癥患者多導睡眠圖分析[J]. 中國行為醫學科學, 2005, 14(3): 246.
16. 王淑萍, 王靜. 側隱窩聯合皮內給予復方倍他米松對老年人腰骶段帶狀皰疹后神經痛的療效[J]. 鄭州大學學報: 醫學版, 2014, 49(2): 281-283, 284.
17. Kost RG, Straus SE. Postherpetic neuralgia-pathogenesis, treatment, and prevention[J]. N Engl J Med, 1996, 335(1): 32-42.

West China Medical Journal

Clinical Study of Intradermal Block Treatment for Post-herpetic Neuralgia Using Different Dose of Compound Betamethasone

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