title: High thoracic epidural block relieves acute herpetic pain involving the trigeminal and cervical regions: comparison with effects of stellate ganglion block.
abstract: OBJECTIVE
  Stellate ganglion block can promptly relieve acute herpetic pain (AHP) involving the trigeminal and cervical regions. However, repeated blocks are needed to maintain pain relief in most patients with severe AHP. Because continuous epidural block is easily performed using an indwelling catheter, we compared the effect of high thoracic epidural block with that of stellate ganglion block to relieve moderate-to-severe AHP involving these regions.
  
  
  METHODS
  Six patients received stellate ganglion blocks and seven patients received high thoracic epidural blocks. Six milliliters 1% of mepivacaine was given to each patient. Acute herpetic pain was evaluated before and up to 60 minutes after the blocks, using a visual analog scale (VAS) of pain.
  
  
  RESULTS
  There was no significant difference in VAS pain scores before the blocks between the groups, but there were significant (P < .05) decreases in VAS pain scores for both groups between 10 and 60 minutes after the blocks. There were no significant differences in VAS pain scores between the groups after the blocks.
  
  
  CONCLUSIONS
  High thoracic epidural block was as effective as stellate ganglion block in relieving moderate-to-severe AHP involving the trigeminal and cervical regions.
authors.affiliation: Department of Anesthesiology, School of Medicine, Fukuoka University, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Higa
authors.forename: K
authors.initials: K
authors.lastname: Hori
authors.forename: I
authors.initials: I
authors.lastname: Harasawa
authors.forename: K
authors.initials: K
authors.lastname: Hirata
authors.forename: K
authors.initials: K
authors.lastname: Dan
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000767:Anesthesia, Epidural; D005260:Female; D006562:Herpes Zoster / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D059408:Pain Management; D013233:Stellate Ganglion; D014277:Trigeminal Neuralgia / Q000628:therapy