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    Home > Active Ingredient News > Study of Nervous System > [Pain topic] Transforaminal epidural steroids for herpes zoster-related pain: the golden age for best results

    [Pain topic] Transforaminal epidural steroids for herpes zoster-related pain: the golden age for best results

    • Last Update: 2021-12-05
    • Source: Internet
    • Author: User
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    Click on the blue text for more preferential information Transforaminal Epidural Steroid Injection for Zoster-Related Pain: The Golden Period for the Best OutcomePain Physician 2021; 24:E669-E676 • ISSN 2150-1149 https:External steroid injection for the treatment of herpes zoster-related pain: the golden age of best results BackgroundZoster-related pain (ZRP) has many negative effects on a patient' s quality of life.
    The transforaminal steroid injection (TFESI), which reduces neural inflammation and pain , has been advocated by pain physicians.
    Many reports demonstrated that early administration of TFESI showed better efficacy; however, the golden period during which TFESI is most effective remains unclear Negative impact
    .

    Injecting steroids (TFESI) through the intervertebral foramen can reduce neuroinflammation and pain, and has been advocated by pain physicians
    .

    Many reports have shown that early use of TFESI shows better efficacy.
    However, the golden age of TFESI is still unclear
    .

    Objectives This multicentre retrospective cohort study aimed to identify the golden period by which TFESI yields the best outcome in patients with ZRP
    .

    MethodsAfter performing the TFESI in patients with ZRP, the patients were classified into two groups: the effective group (E) and the not effective group (N) based on the changes in the pain intensity 3 months after the TFESI.
    The receiver operating characteristic ( ROC) curve analysis was used to assess the cut-off time point for predicting TFESI effectiveness.
    Furthermore, a logistic regression analysis was performed to identify patients' factors associated with a successful treatment outcome The pain intensity changes in 3 months, the patients were divided into effective group (E group) and ineffective group (N group)
    .

    Receiver operating characteristic (ROC) curve analysis is used to evaluate the cut-off time point for predicting the efficacy of TFESI
    .

    In addition, a logistic regression analysis was performed to determine patient factors related to successful treatment outcome
    .

    Result Of the 302 patients, 186 and 116 patients were classified into the E and N group, respectively.
    ROC curve analysis showed that the best cut-off time point for TFESI was 12 weeks (95% confidence interval [CI]; 10-14 weeks) after the onset of HZ.
    The only variable associated with a favorable outcome was a symptom duration of ≤ 12 weeks compared with> 12 weeks (Odd ratio, 0.
    107; 95% CI, 0.
    055-0.
    205; P <0.
    001).
    Other patient variables were not significantly associated with the effectiveness of TFESI.
    TFESI was most effective when administered within 12 weeks of the onset of herpes zoster.
    Results: Among 302 patients, 186 cases were divided into E group and 116 cases in N group
    .

    ROC curve analysis showed that the best cut-off point for TFESI was 12 weeks after the onset (95% confidence interval; 10-14 weeks)
    .

    The only variable associated with a favorable outcome was ≤ symptom duration of 12 weeks, rather than> 12 weeks (odd ratio, 0.
    107; 95% CI, 0.
    055-0.
    205; P<0.
    001)
    .

    Other patient variables have no significant correlation with the effectiveness of TFESI
    .

    TFESI is most effective when administered within 12 weeks after the onset of herpes zoster
    .

    Limitation This study was not a prospective randomized controlled trial (RCT) and the follow-up period was only 3 months after TFESI.
    Limitation: This study was not a prospective randomized controlled trial (RCT), and the follow-up period was only 3 months after TFESI
    .

    Conclusion TFESI is more effective when administered within 12 weeks of onset of herpes zoster.
    Conclusion: TFESI is more effective when administered within 12 weeks of onset of herpes zoster
    .

    RefeRences: 1.
    Johnson RW, Rice AS.
    Clinical practice.
    Postherpetic neuralgia.
    N Engl J Med 2014; 371:1526-1533.
    2.
    Opstelten W, Van Wijck AJ, Van Essen GA, et al.
    The PINE study: rationale and design of a randomised comparison of epidural injection of local anaesthetics and steroids versus care-as-usual to prevent postherpetic neuralgia in the elderly [ISRCTN32866390].
    BMC Anesthesiol 2004; 4:2.
    3.
    Kang DH, Kim SY, Kim HG, Park JH, Kim TK , Kim KH.
    Earlier treatment improves the chances of complete relief from postherpetic neuralgia.
    Korean J Pain 2017; 30:214-2194.
    Kim ED, Bak HH, Jo DH, Park HJ.
    Clinical efficacy of transforaminal epidural injection for management of zo5.
    Ster-associated pain: a retrospective analysis.
    Skeletal Radiol 2018; 47:253-260.
    Doo AR, Choi JW, Lee JH, et al.
    The efficacy of selective nerve root block for the long-term outcome of postherpetic neuralgia.
    Korean J Pain 2019; 32:215-222.
    Literature collation and translation: Poi Jin Xiansen
    .

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