title: 5% lidocaine medicated plasters vs. sympathetic nerve blocks as a part of multimodal treatment strategy for the management of postherpetic neuralgia: a retrospective, consecutive, case-series study.
abstract: BACKGROUND
  5% lidocaine medicated plasters (5% LMP) have been appointed as a first-line treatment for post-herpetic neuralgia (PHN), while formerly used sympathetic nerve blocks (SNBs) were recently denied their clinical efficacy. The aim of this study was to compare the results of PHN management with the use of SNBs and 5% LMP as a first-line treatment.
  
  
  METHODS
  This study was designed as a retrospective, consecutive, case-series study. Data of 60 consecutive PHN patients with allodynia treated with the use of SNBs and 60 subsequent patients managed with 5% LMP were analyzed. Pain severity after 8 weeks was assessed to recognize the results of the implemented therapy, with numeric rating scale (NRS) score <3 or =3 considered a success. Additionally, the number of pain-free patients (NRS=0) after 8 weeks were identified in both groups and compared.
  
  
  RESULTS
  The rate of failures in SNBs and 5% LMP group was similar (18.9% vs. 27.1% of poor treatment results, respectively), with the average change in NRS of 5.88 ± 2.41 in nerve blocks and 5.01 ± 1.67 in lidocaine group (p=0.02). Significant difference was also noted in the rates of pain-free patients: 20 patients (34.4%) treated with SNBs and 8 (13.5%) using 5% LMP were pain-free after 8 weeks of treatment.
  
  
  CONCLUSIONS
  It may be concluded that SNBs may still be considered useful in PHN management, as it appears that in some cases this mode of treatment may offer some advantages over 5% LMP.
authors: Pain Clinic: Department of Anesthesiology and Intensive Care, Medical Center for Postgraduate Education, Warsaw, Poland. Electronic address: lmilewski@post.pl.
authors: Małgorzata
authors: M
authors: Malec-Milewska
authors: Pain Clinic: Department of Anesthesiology and Intensive Care, Medical Center for Postgraduate Education, Warsaw, Poland.
authors: Bartosz
authors: B
authors: Horosz
authors: Pain Clinic: Department of Anesthesiology and Intensive Care, Medical Center for Postgraduate Education, Warsaw, Poland.
authors: Agnieszka
authors: A
authors: Sękowska
authors: Pain Clinic: Department of Anesthesiology and Intensive Care, Medical Center for Postgraduate Education, Warsaw, Poland.
authors: Iwona
authors: I
authors: Kolęda
authors: Pain Clinic: Department of Anesthesiology and Intensive Care, Medical Center for Postgraduate Education, Warsaw, Poland.
authors: Hanna
authors: H
authors: Kucia
authors: Pain Clinic: Department of Anesthesiology and Intensive Care, Medical Center for Postgraduate Education, Warsaw, Poland.
authors: Dariusz
authors: D
authors: Kosson
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000494:pharmacology*; D001340:Autonomic Nerve Block / Q000379:methods*; D001458:Bandages; D002045:Bupivacaine / Q000008:administration & dosage / Q000494:pharmacology*; D004837:Epinephrine / Q000008:administration & dosage / Q000494:pharmacology; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D051474:Neuralgia, Postherpetic / Q000188:drug therapy*; D010147:Pain Measurement; D012189:Retrospective Studies; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage / Q000494:pharmacology
chemical_list: D000779:Anesthetics, Local; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D002045:Bupivacaine; D004837:Epinephrine
keywords: Gabapentin; Numeric rating scale; Postherpetic neuralgia; Sympathetic nerve block; Tricyclic antidepressant