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Anesth Analg 2002;94:694-700
© 2002 International Anesthesia Research Society

PAIN MEDICINE

Spinal Cord Stimulation in Postherpetic Neuralgia and in Acute Herpes Zoster Pain

Henning Harke, MD, Peter Gretenkort, MD, Hans Ulrich Ladleif, MD, Peter Koester, MD, and Salah Rahman, MD

Department of Anesthesia and Pain Therapy, Klinikum Krefeld, Krefeld, Germany

Address correspondence and reprint requests to Professor Henning Harke, MD, Department of Anesthesia and Pain Therapy, Klinikum Krefeld, Lutherplatz 40, D-47805 Krefeld, Germany.

We studied the effects of spinal cord stimulation (SCS) on postherpetic neuralgia (PHN). Data of 28 patients were prospectively investigated over a median period of 29 (quartiles 9–39) mo. In addition, four patients with acute herpes zoster (HZ) pain were studied simultaneously. After intractable pain for more than 2 yr, long-term pain relief was achieved in 23 (82%) PHN patients (median, 70 yr) during SCS treatment confirmed by a median decrease from 9 to 1 on the visual analog scale (P < 0.001). In five cases with serious comorbidity, the initial pain alleviation could not be stabilized. Spontaneous improvement was always confirmed or excluded by SCS inactivation tests at quarterly intervals. Eight patients discontinued SCS permanently because of complete pain relief after stimulation periods of 3–66 mo, whereas 2 reestablished SCS because of recrudescence after 2 and 6 mo. Considerable impairments in everyday life, objectified by the pain disability index, were also significantly improved (P < 0.001). In 4 patients with acute HZ pain, SCS was promptly effective and after periods of 2.5 (quartiles 2–3) months the pain had subsided. SCS seems to offer a therapeutic option for pharmacological nonresponders.

IMPLICATIONS: In many patients with postherpetic neuralgia and acute herpes zoster pain is not satisfactorily alleviated with pharmacological approaches. We report on 23 of 28 patients with postherpetic neuralgia and 4 of 4 with acute herpes zoster whose chronic pain was improved by electrical spinal cord stimulation.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2002 by the International Anesthesia Research Society.