• Heezoo Kim, Yoon-La Choi, Dong Kyu Lee, Sang Sik Choi, Il Ok Lee, Myoung Hoon Kong, Nan Sook Kim, Sang Ho Lim, and Mikyoung Lee.
• Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Seoul, South Korea.
• Pain Physician. 2012 Jan 1;15(1):E107-13.

BackgroundEffective early antiviral treatments reduce both acute zoster pain and the risk of postherpetic neuralgia. The authors hypothesized that the direct neuraxial administration of acyclovir could provide superior drug application to the spinal neural structures with a higher viral burden and have various advantages over the other routes of drug administration in terms of required doses, side effects, and efficacy.ObjectiveTo know whether intrathecal acyclovir injection is neurologically and histopathologically safe or not.Study DesignRandomized, experimental trial in rats.SettingAssociated experiment center.MethodsA total of 40 rats weighing between 250-300g were used. The rats were randomly divided into 2 groups of 20 each using a random number table: normal saline group (Group N) and acyclovir group (Group A). Rats in Group N were administered 20 μl of normal saline and Group A were administered the same volume of 700 μg/mL acyclovir into the intrathecal space via an intrathecal catheter. Saline or acyclovir was administered daily for 5 consecutive days. The changes in behavior and sensory-motor function were checked and histopathological findings of the spinal cords were observed by light and electron microscopy.ResultsNo rats in Group N or Group A showed any behavioral change or sensory-motor dysfunction during the 5-day observation period. Furthermore, no histopathological abnormalities of the spinal cord were observed in the 6th day after the last intrathecal administration of the drug.LimitationsThere is a need to perform studies to evaluate long-term safety by observing cumulative neurotoxic effects with continual injection during a long-term period.ConclusionsThere was no evidence of neurological and histopathological abnormalities following intrathecal acyclovir injection.

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