BACKGROUND Continuous epidural infusions are commonly used in clinical settings to reduce the likelihood of transition to postherpetic neuralgia via pain control. The purpose of this study was to compare the efficacy of conventional continuous epidural infusion to that of continuous epidural infusion in which the catheter is guided by electric stimulation to areas with neurological damage for the treatment of zoster-related pain and prevention of postherpetic neuralgia. METHODS We analyzed the medical records of 114 patients in this study. The patients were divided into two groups: contrast (conventional continuous epidural infusion) and stimulation (continuous epidural infusion with epidural electric stimulation). In the contrast group, the position of the epidural catheter was confirmed using contrast medium alone, whereas in the stimulation group, the site of herpes zoster infection was identified through electric stimulation using a guidewire in the catheter. Clinical efficacy was assessed using a numerical rating scale (pain score) up to 6 months after the procedures. We compared the percentage of patients who showed complete remission (pain score less than 2 and no further medication) in each group. We also investigated whether the patients required additional interventional treatment due to insufficient pain control during the 6-month follow-up period after each procedure. RESULTS After adjusting for confounding variables, the pain score was significantly lower in the stimulation group than in the contrast group for 6 months after the procedure. After adjustment, the odds of complete remission were 1.9-times higher in the stimulation group than in the contrast group (95% confidence interval [CI]: 0.81-4.44, P = 0.14). Patients in the contrast group were significantly more likely to require other interventions within 6 months of the procedure than patients in the stimulation group (odds ratio: 3.62, 95% CI: 1.17-11.19, P = 0.03). CONCLUSION Epidural drug administration to specific spinal segments using electric stimulation catheters may be more helpful than conventional continuous epidural infusion for improving pain and preventing postherpetic neuralgia in the acute phase of herpes zoster.

中文翻译：

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与常规连续硬膜外输注相比，连续硬膜外输注硬膜外电刺激治疗急性带状疱疹的疗效：一项回顾性研究。

背景技术连续硬膜外输注通常用于临床环境中，以减少通过疼痛控制而转变为疱疹后神经痛的可能性。这项研究的目的是比较常规硬膜外连续输注与连续硬膜外输注的效果，在连续硬膜外输注中，通过电刺激将导管引导至具有神经损伤的区域，以治疗带状疱疹相关的疼痛和预防带状疱疹后神经痛。方法我们分析了这项研究中114例患者的病历。将患者分为两组：对比（常规连续硬膜外输注）和刺激（连续硬膜外输注硬膜外电刺激）。在对比组中，仅使用对比剂可确定硬膜外导管的位置，而在刺激组中，通过导管中的导丝通过电刺激来识别带状疱疹感染的部位。在手术后最多6个月使用数字评分量表（疼痛评分）评估临床疗效。我们比较了每组中显示完全缓解（疼痛评分小于2并且没有进一步用药）的患者百分比。我们还调查了在每次手术后6个月的随访期间，患者是否由于疼痛控制不足而需要额外的介入治疗。结果校正混杂变量后，术后6个月，刺激组的疼痛评分明显低于对照组。调整后，完全缓解的几率是1。刺激组比对照组高9倍（95％置信区间[CI]：0.81-4.44，P = 0.14）。与刺激组相比，对比组患者在手术后6个月内更有可能需要其他干预措施（优势比：3.62，95％CI：1.17-1.19，P = 0.03）。结论使用电刺激导管将硬膜外药物施用于特定的脊柱节段可能比常规连续硬膜外输注对改善带状疱疹急性期疼痛和预防带状疱疹后神经痛有更大的帮助。1.17-11.19，P = 0.03）。结论使用电刺激导管将硬膜外药物施用于特定的脊柱节段可能比常规连续硬膜外输注对改善带状疱疹急性期疼痛和预防带状疱疹后神经痛有更大的帮助。1.17-11.19，P = 0.03）。结论使用电刺激导管将硬膜外药物施用于特定的脊柱节段可能比常规连续硬膜外输注对改善带状疱疹急性期疼痛和预防带状疱疹后神经痛有更大的帮助。