应用超声引导胸椎旁阻滞或肋间神经阻滞治疗急性带状疱疹和预防带状疱疹后遗神经痛:病例对照回顾性试验。

IF 1.5 Q4 CLINICAL NEUROLOGY
Scandinavian Journal of Pain Pub Date : 2024-07-09 eCollection Date: 2024-01-01 DOI:10.1515/sjpain-2024-0030
Mianrong Xue, Rong Yuan, Yanwei Yang, Zhenlong Qin, Runqiao Fu
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引用次数: 0

摘要

目的:超声(US)引导下的肋间神经阻滞(ICNB)是一种在不同手术中并发症发生率极低的简便方法;然而,只有少数研究估计了 ICNB 对急性带状疱疹的治疗效果。目的:以传统的胸椎旁阻滞(TPVB)为对照,探讨 US 引导下 ICNB 治疗带状疱疹(HZ)相关急性疼痛以及预防带状疱疹后遗神经痛(PHN)的可能性:对128名HZ患者进行回顾性分层,根据他们接受的治疗分为抗病毒治疗(AVT)加US引导TPVB组(TPVB组)、AVT加US引导ICNB组(ICNB组)或单纯AVT组(对照组)。作为主要终点,HZ相关疾病负担(HZ-BOI)在入组后的30天内通过按疼痛严重程度和持续时间进行的综合疼痛评估来确定。此外,还记录了止痛药需求量、与健康相关的生活质量、PHN发生率和不良事件:结果:与对照组相比,TPVB 和 ICNB 术后 30 天内的 HZ-BOI 评分明显降低(采用曲线下面积法):平均分别为 57.5 分(p < 0.001)和 40.3 分(p = 0.003)。TPVB 和 ICNB 之间无差异(p = 1.01)。在随访期间,观察到两个试验组在PHN发生率、EQ-5D-3L评分和抢救镇痛剂需求方面均有明显改善,而两个试验组之间则具有可比性。未观察到严重不良事件:结论:US引导下的ICNB与TPVB治疗急性HZ同样有效。与传统的 TPVB 相比,ICNB 技术是一种更简便、更省时的方法,可作为预防 PHN 的一种更便捷的先发手段加以推广。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Application of ultrasound-guided thoracic paravertebral block or intercostal nerve block for acute herpes zoster and prevention of post-herpetic neuralgia: A case-control retrospective trial.

Objectives: Ultrasound (US)-guided intercostal nerve block (ICNB) is an easier approach with a very low incidence of complications for different surgeries; nevertheless, only a few studies estimate the effect of ICNB for acute HZ. To explore the US-guided ICNB for management of herpes zoster (HZ)-related acute pain and possible prophylaxis for post-herpetic neuralgia (PHN) taking the conventional thoracic paraverteral block (TPVB) as control.

Methods: A total of 128 patients with HZ were retrospectively stratified into antiviral treatment (AVT) plus US-guided TPVB (TPVB group), AVT plus US-guided ICNB (ICNB group) or AVT alone (control group) based on the treatment they received. HZ-related illness burden (HZ-BOI) over 30 days after inclusion as the primary endpoint was determined by a severity-by-duration composite pain assessment. Rescue analgesic requirement, health-related quality of life, PHN incidence, and adverse events were also recorded.

Results: Significantly lower HZ-BOI scores within post-procedural 30 days using the area under the curve were reported with TPVB and ICNB compared with the control group: mean difference of 57.5 (p < 0.001) and 40.3 (p = 0.003). No difference was reported between TPVB and ICNB (p = 1.01). Significant greater improvements in PHN incidence, EQ-5D-3L scores, and rescue analgesic requirements were observed during follow-up favoring two trial groups, while comparable between two trial groups. No serious adverse events were observed.

Conclusions: US-guided ICNBs were as effective as TPVBs for acute HZ. The ICNB technique was an easier and time-efficient approach as opposed to conventional TPVB, which might be encouraged as a more accessible preemptive mean for preventing PHN.

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来源期刊
Scandinavian Journal of Pain
Scandinavian Journal of Pain CLINICAL NEUROLOGY-
CiteScore
3.30
自引率
6.20%
发文量
73
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