The Korean Journal of Pain

  • 제30권1호
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  • Pages.62-65
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  • 2017
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  • 2005-9159(pISSN)
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  • 2093-0569(eISSN)
대한통증학회 (The Korean Pain Society)
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Psoas compartment block for treatment of motor weakness and pain following herpes zoster

  • Kim, Sae Young (Department of Anesthesiology and Pain Medicine, Kyungpook National University Hospital) ;
  • Kim, Dong Gyeong (Department of Anesthesiology and Pain Medicine, Kyungpook National University Hospital) ;
  • Park, Yong Min (Department of Anesthesiology and Pain Medicine, Kyungpook National University Hospital) ;
  • Jeon, Young Hoon (School of Dentistry, Kyungpook National University)
  • 투고 : 2016.05.09
  • 심사 : 2016.08.22
  • 발행 : 2017.01.01
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초록

Reactivation of the latent varicella zoster virus in the sensory ganglion causes herpes zoster (HZ). Its characteristic symptom is a painful rash in the involved dermatome. HZ-induced motor weakness is rare and is usually resolved within one year of the onset, but some patients permanently experience motor dysfunction. Epidural steroid administration, with antiviral therapy, can be effective in treating pain from HZ and preventing postherpetic neuralgia. But an epidural block is contraindicated in patients receiving thromboprophylaxis. A psoas compartment block (PCB) provides equivalent analgesic efficacy with significantly low incidence of complication, compared to an epidural block. A 68 year old male patient recieving thromboprophylaxis presented with motor weakness following painful rash in his left L4 dermatome. Ten days before presentation, herpetic rash occurred on his left leg. We performed PCB with a steroid and local anesthetic, which successfully and safely alleviated the pain and motor weakness from HZ.

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참고문헌

  1. Jeon YH. Herpes zoster and postherpetic neuralgia: practical consideration for prevention and treatment. Korean J Pain 2015; 28: 177-84. https://doi.org/10.3344/kjp.2015.28.3.177
  2. Lee MH, Song JH, Lee DI, Ahn HS, Park JW, Cha YD. Newly developed urinary retention and motor weakness of lower extremities in a postherpetic neuralgia patient. Korean J Pain 2013; 26: 76-9. https://doi.org/10.3344/kjp.2013.26.1.76
  3. Chernev I, Dado D. Segmental zoster abdominal paresis (zoster pseudohernia): a review of the literature. PM R 2013; 5: 786-90. https://doi.org/10.1016/j.pmrj.2013.05.013
  4. Kim JG, Chung SG. Herpetic brachial plexopathy: application of brachial plexus magnetic resonance imaging and ultrasound-guided corticosteroid injection. Am J Phys Med Rehabil 2016; 95: e67-71.
  5. Kumar V, Krone K, Mathieu A. Neuraxial and sympathetic blocks in herpes zoster and postherpetic neuralgia: an appraisal of current evidence. Reg Anesth Pain Med 2004; 29: 454-61.
  6. Vandermeulen EP, Van Aken H, Vermylen J. Anticoagulants and spinal-epidural anesthesia. Anesth Analg 1994; 79: 1165-77.
  7. Moen V, Dahlgren N, Irestedt L. Severe neurological complications after central neuraxial blockades in Sweden 1990-1999. Anesthesiology 2004; 101: 950-9. https://doi.org/10.1097/00000542-200410000-00021
  8. Turker G, Uckunkaya N, Yavascaoglu B, Yilmazlar A, Ozcelik S. Comparison of the catheter-technique psoas compartment block and the epidural block for analgesia in partial hip replacement surgery. Acta Anaesthesiol Scand 2003; 47: 30-6. https://doi.org/10.1034/j.1399-6576.2003.470106.x
  9. Florence JM, Pandya S, King WM, Robison JD, Baty J, Miller JP, et al. Intrarater reliability of manual muscle test (Medical Research Council scale) grades in Duchenne's muscular dystrophy. Phys Ther 1992; 72: 115-22. https://doi.org/10.1093/ptj/72.2.115
  10. Jones LK Jr, Reda H, Watson JC. Clinical, electrophysiologic, and imaging features of zoster-associated limb paresis. Muscle Nerve 2014; 50: 177-85. https://doi.org/10.1002/mus.24141
  11. Mondelli M, Romano C, Rossi S, Cioni R. Herpes zoster of the head and limbs: electroneuromyographic and clinical findings in 158 consecutive cases. Arch Phys Med Rehabil 2002; 83: 1215-21. https://doi.org/10.1053/apmr.2002.33989
  12. Conliffe TD, Dholakia M, Broyer Z. Herpes zoster radiculopathy treated with fluoroscopically-guided selective nerve root injection. Pain Physician 2009; 12: 851-3.
  13. Horlocker TT, Wedel DJ, Benzon H, Brown DL, Enneking FK, Heit JA, et al. Regional anesthesia in the anticoagulated patient: defining the risks (the second ASRA Consensus Conference on Neuraxial Anesthesia and Anticoagulation). Reg Anesth Pain Med 2003; 28: 172-97.
  14. Kim S, Jeon Y. Treatment of abdominal segmental hernia, constipation, and pain following herpes zoster with paravertebral block. Pain Physician 2015; 18: E927-9.
  15. Parkinson SK, Mueller JB, Little WL, Bailey SL. Extent of blockade with various approaches to the lumbar plexus. Anesth Analg 1989; 68: 243-8.
  16. Chelly JE, Clark LD, Gebhard RE, Raw RM, Atchabahian A. Consensus of the Orthopedic Anesthesia, Pain, and Rehabilitation Society on the use of peripheral nerve blocks in patients receiving thromboprophylaxis. J Clin Anesth 2014; 26: 69-74. https://doi.org/10.1016/j.jclinane.2013.09.012
  17. Hardy D. Relief of pain in acute herpes zoster by nerve blocks and possible prevention of post-herpetic neuralgia. Can J Anaesth 2005; 52: 186-90. https://doi.org/10.1007/BF03027727

피인용 문헌

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  2. Treatment of great auricular neuralgia with real-time ultrasound-guided great auricular nerve block vol.96, pp.12, 2017, https://doi.org/10.1097/md.0000000000006325
  3. Caudal block with steroid in the treatment of acute voiding dysfunction and pain caused by sacral herpes zoster : A case report vol.99, pp.25, 2017, https://doi.org/10.1097/md.0000000000020680