Does interventional pain management during the acute phase of herpes zoster prevent postherpetic neuralgia? A meta-analysis = Does interventional pain management during the acute phase of herpes zoster prevent postherpetic neuralgia? A meta-analysis

다국어 초록 (Multilingual Abstract)

Background: Although several interventional procedures (IPs) such as epidural sympathetic block and neuromodulation for reducing the acute pain of herpes zoster (HZ) have been indicated to have some level of effectiveness in the prevention of postherpetic neuralgia (PHN), no conclusive evidence is present for this issue. Objectives: To examine the efficacy of interventional pain management during the acute phase of HZ (within 14 days after onset of the rash) in preventing PHN Methods: Databases we used included PubMed, SCOPUS and references of retrieved articles from inception to August 2013, with no limits on the study date or language. A total of 1960 literatures were reviewed. Included studies were randomized controlled and cohort trials that compared IPs, which were combined with standard antiviral therapy aiming at preventing PHN, with antiviral therapy only. Studies must have included VAS for pain assessment. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by using Comprehensive Meta Analysis Version 2.0. Results: Five studies of a total of 1413 patients were ultimately included. The results showed IPs combined with antiviral therapy during acute HZ had a preventive effect on the development of PHN over antiviral therapy only at 3 months (ORs 3.28, 95% CIs 1.20 to 8.96; p=0.02) and 6 months (ORs 3.86, 95% CIs 1.25 to 11.89; p=0.02). Conclusion: Current evidence shows that in preventing PHN, interventional pain management can be effective during acute HZ.