Case reports: zoster pain in haematological malignancies: effective pain relief with oxycodone in patients unresponsive to other analgesic measures.
Varicella zoster virus (VZV) outbreak is a significant cause of morbidity in patients suffering from blood-related malignancies, occurring mostly among those affected by lymphoproliferative disorders and in those receiving haematopoietic stem-cell transplantation. The elucidated pathological mechanisms of VZV-related painful complications have provided the rationale for acute zoster pain (AZP) and post-herpetic neuralgia (PHN) treatment with antiviral therapy combined with neuroactive agents, such as tricyclic or anticonvulsant agents. The role of opioids in this setting is less clearly established. We successfully treated (with oxycodone) 12 consecutive patients suffering from AZP and long-lasting PHN resistant to several agents, including anticonvulsants and analgesics. Our experience is reported together with a brief overview of the management of these often distressing and intractable complications.
Niscola
Pasquale
P
Haematology Division, Sant'Eugenio Hospital, Tor Vergata University, Rome, Italy. pasquale.niscola@uniroma2.it
Perrotti
Alessio Pio
AP
del Poeta
Giovanni
G
Romani
Claudio
C
Palombi
Massimiliano
M
Piccioni
Daniela
D
Scaramucci
Laura
L
Tolu
Barbara
B
Tendas
Andrea
A
Cupelli
Luca
L
Abruzzese
Elisabetta
E
D'Elia
Gianna Maria
GM
Brunetti
Gregorio Antonio
GA
Maurillo
Luca
L
Giovannini
Marco
M
Cartoni
Claudio
C
de Fabritiis
Paolo
P
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D000588:Amines / Q000008:administration & dosage / Q000627:therapeutic use; D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D000077206:Gabapentin; D019337:Hematologic Neoplasms / Q000150:complications*; D006562:Herpes Zoster / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D051474:Neuralgia, Postherpetic / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control; D010098:Oxycodone / Q000008:administration & dosage / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology*; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage / Q000627:therapeutic use
D000588:Amines; D000700:Analgesics; D000998:Antiviral Agents; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D010098:Oxycodone