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Sunday, April 20, 2014
Spinal Block For PHN (Shingles) Pain?
My 85-yr-old father has had PHN in his thigh/buttock for 15 months. His GP has referred him to an anesthesiologist who wants to perform a spinal block(s) for pain mitigation. Is this common? Effective? Risky? For how long would it alleviate the pain?
At this stage of the condition (PHN), it is not known if spinal blocks/sympathetic blocks would be useful. However, the risk of the procedure is low and if the relief is long-lasting (only the patient is able to tell) then it may be worthwhile repeating. Again, there is no evidence for effectiveness at this stage (PHN). There is some debatable evidence of effectiveness in the acute herpetic stage (when the rash first erupted) in preventing or decreasing the incidence of PHN. If your father does not get significant or long-lasting relief from one block, there would be no reason to repeat it. In that case, there are some other options that a specialized pain center such as University Hospitals Case Medical Center can offer.
Salim M Hayek, MD, PhD
Associate Professor of Anesthesiology & Perioperative Medicine
School of Medicine
Case Western Reserve University