Two patients with herpes zoster-associated pain in the subacute phase successfully treated with intravenous lidocaine

Abstract

We report two patients with herpes zoster-associated pain (ZAP) in the subacute phase that responded to intravenous drip infusion of lidocaine. Patient 1 was a 70-year-old man who presented with herpes zoster on the right Th4 region. He was not responding to pregabalin 150 mg/day for electric shock-like pain and sleep disturbance, then he visited our hospital a month after the onset. He presented with a VAS of 80 mm and allodynia. Because he was on antithrombotic therapy for cerebral infarction, nerve block could not be performed. Patient 2 was a 69-year-old man with left Th5 herpes zoster. He presented with a VAS of 70 mm and allodynia. Allodynia disappeared immediately after intercostal nerve block and intravenous lidocaine infusion of 100 mg. Lidocaine infusion is a simple and effective adjunctive therapy for ZAP with allodynia in the sub-acute phase when nerve block cannot be performed, such as during antithrombotic therapy.