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High Thoracic Epidural Block Relieves Acute Herpetic Pain Involving the Trigeminal and Cervical Regions: Comparison With Effects of Stellate Ganglion Block
  1. Kazuo Higa, M.D.*,
  2. Koichiro Hori, M.D.*,
  3. Ichiro Harasawa, M.D.*,
  4. Kazuhiko Hirata, M.D.* and
  5. Kenjiro Dan, M.D.*
  1. *From the Department of Anesthesiology, School of Medicine, Fukuoka University, Fukuoka, Japan.
  1. Reprint requests: Kazuo Higa, M.D., Department of Anesthesiology, School of Medicine, Fukuoka University, 45-1, 7-chome, Nanakuma, Jonan-ku, Fukuoka 814-80, Japan.


Background and Objectives Stellate ganglion block can promptly relieve acute herpetic pain (AHP) involving the trigeminal and cervical regions. However, repeated blocks are needed to maintain pain relief in most patients with severe AHP. Because continuous epidural block is easily performed using an indwelling catheter, we compared the effect of high thoracic epidural block with that of stellate ganglion block to relieve moderate-to-severe AHP involving these regions.

Methods Six patients received stellate ganglion blocks and seven patients received high thoracic epidural blocks. Six milliliters 1% of mepivacaine was given to each patient. Acute herpetic pain was evaluated before and up to 60 minutes after the blocks, using a visual analog scale (VAS) of pain.

Results There was no significant difference in VAS pain scores before the blocks between the groups, but there were significant (P < .05) decreases in VAS pain scores for both groups between 10 and 60 minutes after the blocks. There were no significant differences in VAS pain scores between the groups after the blocks.

Conclusions High thoracic epidural block was as effective as stellate ganglion block in relieving moderate-to-severe AHP involving the trigeminal and cervical regions.

  • acute herpetic pain
  • herpes zoster
  • stellate ganglion block
  • thoracic epidural block
  • varicella-zoster virus.

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  • This study was done at Fukuoka University Hospital and was supported in part by a grant from the Ministry of Education, Science, Sports and Culture of Japan (#08671780).

    This study was presented in part at the 8th World Congress of Pain in Vancouver, Canada, August, 1996.