Chronic opioid therapy as alternative treatment for post-herpetic neuralgia.
Neurosurgical procedures such as the dorsal root entry zone operation, ganglionectomy, and spinal-cord stimulation have been offered to patients with intractable post-herpetic neuralgia (PHN). Poor efficacy or high morbidity have limited the overall usefulness of these procedures. We recently conducted a preliminary open-label study with long-acting oral opioids. The mean pretreatment pain score, on a scale of 0 to 10 (0 = no pain) was 9.0 +/- 0.3 (mean +/- SEM, N = 20). At two months of treatment the average pain score was 4.0 +/- 0.4 (p < 0.001, paired t test), and at six months the average pain score was 3.8 +/- 0.2 (p < 0.001, N = 16). These observations warrant a controlled opioid trial for patients affected by PHN.
Pappagallo
M
M
Dept of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD 21287.
Campbell
J N
JN
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003692:Delayed-Action Preparations; D005157:Facial Pain / Q000188:drug therapy / Q000209:etiology; D005500:Follow-Up Studies; D006562:Herpes Zoster / Q000150:complications*; D006801:Humans; D006930:Hyperalgesia / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D009437:Neuralgia / Q000188:drug therapy* / Q000503:physiopathology; D010146:Pain / Q000503:physiopathology
D003692:Delayed-Action Preparations; D009020:Morphine