KRONİK BÖBREK YETMEZLİĞİ OLAN HASTADA HERPES ZOSTER KAYNAKLI AĞRININ TEDAVİSİNDE EREKTÖR SPİNA PLAN BLOĞU

Year 2024, Volume: 57 Issue: 1, 41 - 43, 30.04.2024

Yılmaz Karaduman , Arzu Muz , Azize Serçe , Yusuf Harun İren , Suna Akın Takmaz

https://doi.org/10.20492/aeahtd.1329851

Abstract

Herpes zoster, varisella zoster virüsünün reaktivasyonuyla ortaya çıkan bir hastalık olup ağrı ve ciltte veziküllü döküntüler şeklinde semptom verir. Semptomlar hastaların uyku, yaşam kalitesini ve günlük aktivitelerini olumsuz yönde etkileyebilmektedir. Herpes zoster kaynaklı ağrının yönetiminde medikal tedaviyle birlikte epidural, intratekal, somatik veya sempatik sinir blokları denenebilir. Sistemik hastalık varlığında ilaç kullanımı kısıtlanabileceği gibi omurga ve spinal kord anamolisi ve/veya deformitesi varlığında nöroaksiyel blokların komplikasyon riski artar, ayrıca uygulamada zorluklarla karşılaşılabilir. Olgumuzda torakal bölgede zonaya bağlı şiddetli akut ağrı tedavisinde erektör spina plan bloğu uygulanan, renal yetmezlikli, omurga ve spinal kord anamolisi olan bir olgu sunulmuştur.

Keywords

Erektör spina plan bloğu, herpes zoster, post herpetik nevralji

ERECTOR SPINA PLAN BLOCK IN THE TREATMENT OF HERPES ZOSTER-INDUCED PAIN IN A PATIENT WITH CHRONIC RENAL FAILURE

Abstract

Herpes zoster is a disease caused by reactivation of the varicella zoster virus and is characterized by pain and vesicular rashes on the skin. Symptoms can negatively affect patients' sleep, quality of life and daily activities. In the management of herpes zoster-induced pain, epidural, intrathecal, somatic or sympathetic nerve blocks may be tried along with medical treatment. The use of drugs may be restricted in the presence of systemic disease, and the risk of complications of neuraxial blocks increases in the presence of spinal and spinal cord anamolysis and/or deformity, and difficulties may be encountered in their application. In our case report, we present a patient with renal failure and spinal cord anamolysis who underwent erector spina plan block in the treatment of severe acute pain due to shingles in the thoracic region.

Keywords

Erector spinae plane block, herpes zoster, post herpetic neuralgia

References

• 1. Gnann JW Jr, Whitley RJ. Clinical practice. Herpes zoster. N Engl J Med. 2002;347(5):340-6. doi:10.1056/NEJMcp013211.
• 2. Mueller NH, Gilden DH, Cohrs RJ, Mahalingam R, Nagel MA. Varicella zoster virus infection: clinical features, molecular pathogenesis of disease, and latency. Neurol Clin. 2008;26(3):675-97, viii. doi:10.1016/j.ncl.2008.03.011.
• 3. Seo YG, Kim SH, Choi SS, Lee MK, Lee CH, Kim JE. Effectiveness of continuous epidural analgesia on acute herpes zoster and postherpetic neuralgia: A retrospective study. Medicine (Baltimore). 2018;97(5):e9837. doi:10.1097/MD.0000000000009837.
• 4. Johnson RW. Consequences and management of pain in herpes zoster. J Infect Dis. 2002;186 Suppl 1:S83-S90. doi:10.1086/342970.
• 5. Mallick-Searle T, Snodgrass B, Brant JM. Postherpetic neuralgia: epidemiology, pathophysiology, and pain management pharmacology. J Multidiscip Healthc. 2016;21:9:447- 54. doi: 10.2147/JMDH.S106340.
• 6. van Wijck AJ, Wallace M, Mekhail N, van Kleef M. Evidence- based interventional pain medicine according to clinical diagnoses. 17. Herpes zoster and post-herpetic neuralgia. Pain Pract. 2011;11(1):88-97. doi:10.1111/j.1533- 2500.2010.00428.x.
• 7. Kanazi GE, Johnson RW, Dworkin RH. Treatment of postherpetic neuralgia: an update. Drugs. 2000;59(5):1113-26. doi:10.2165/00003495-200059050-00007.
• 8. Aydın T, Balaban O, Ahiskalioglu A, et al. Ultrasound-guided Erector Spinae Plane Block for the Management of Herpes Zoster Pain: Observational Study. Cureus. 2019;11(10):e5891. doi: 10.7759/cureus.5891.
• 9. Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ. The Erector Spinae Plane Block: A Novel Analgesic Technique in Thoracic Neuropathic Pain. Reg Anesth Pain Med. 2016;41(5):621-7. doi:10.1097/AAP.0000000000000451.
• 10. Gündoğdu Z, Özkan Z, Gündoğdu T. Torasik Herpes Zostere Bağlı Ağrı Olgusunda Ultrasonografi Rehberliğinde Erektör Spina Plan Bloğu. Çukurova Anestezi ve Cerrahi Bilimler Dergisi. 2020 özel sayı 1, 6-10. DOI: 10.36516/jocass. 2020.34.
• 11. Yu SY, Fan BF, Yang F, et al. Patient and economic burdens of postherpetic neuralgia in China. Clinicoecon Outcomes Res. 2019;11:539-50. doi:10.2147/CEOR.S203920.