The effect of neural block with local anesthetics combined with amitriptyline on post-herpetic neuralgia

Abstract

We retrospectively ivestigated the effect of neural block with local anesthetics on post-herpetic neuralgia (PHN) in 6 patients. The regions of herpes zoster were the ophthalmic nerve area in 3 patients, cervical nerve area in 1 patient and thoracic nerve area in 2 patients. The interval between the onset of herpetic pain and the begining of neural block was longer than 1 year. The mean interval was 31.5 months. The mean follow-up period was 19 months. These patients received stellate ganglion block or epidural block once or twice a week in the first 1-2 months. After that the frequency of neural block was gradually decreased in each case. They were simultaneously administered amitriptyline 10-20mg/day from the beginning of the treatment. Remarkable pain relief was obtained in five of the six cases in four weeks. It has been reported that neural block has little effect on established post-herpetic neuralgia. However, appreciable pain relief is possible by neural block with local anesthetics accompanied by oral amitriptyline, even in patients suffering from herpetic pain for over 1 year.