Nederlands tijdschrift voor geneeskunde
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Ned Tijdschr Geneeskd · Dec 2006
Randomized Controlled Trial[Treatment of patients with herpes zoster by epidural injection of steroids and local anaesthetics: less pain after 1 month, but no effect on long-term postherpetic neuralgia--a randomised trial].
To assess the effectiveness of a single epidural injection of steroids and local anaesthetics, as a supplement to the standard treatment, for the prevention ofpostherpetic neuralgia in older patients with herpes zoster. ⋯ A single epidural injection of steroids and local anaesthetics in the acute phase of herpes zoster resulted in a modest decrease in zoster-associated pain in the first month. This treatment did not, however, prevent long-term postherpetic neuralgia.
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Ned Tijdschr Geneeskd · Dec 2006
Comment[Limited possibilities for the evidence-based treatment and prevention of postherpetic neuralgia].
Postherpetic neuralgia is a disorder that occurs frequently in the elderly. As the effect of the treatment of postherpetic neuralgia is often disappointing, studies have focussed on the prevention of this complaint. A commonly used preventive intervention is the administration ofa single epidural injection of a local anaesthetic and a corticosteroid, combined with oral antiviral agents and analgesics. In a large, multicentre, randomised controlled trial, the investigators found that the single injection of a corticosteroid and a local anaesthetic had no added value in the prevention of long-term postherpetic neuralgia.