Chinese Journal of Geriatrics | 2019
Ultrasound-guided transversus abdominis plane block for elderly herpetic neuralgia located in anterior abdominal wall: a randomized and controlled trial
Abstract
Objective \nTo evaluate the efficacy of ultrasound-guided transversus abdominis plane block for elderly herpetic neuralgia located in anterior abdominal wall. \n \n \nMethods \nA total of 112 elderly patients aged 65-75 years with less than 30 days of herpes zoster neuralgia located in anterior abdominal wall were enrolled for receiving a treatment of transversus abdominis plane block.Patients were randomly allocated into two groups: the control group(n=56)taking gabapentin and celebrex, and the observation group(n=56)receiving transversus abdominis plane block(three times per week for two weeks)as add on therapy to gabapentin and celebrex.Morphine 10 mg was ready for oral application in breakthrough pain.Pain was evaluated by McGill scores assessed by short-form of Mcgill pain questionnaire(SF-M PQ)and visual analogue scale(VAS)before(T0)and after 1(T1)and 2 weeks(T2)of transversus abdominis plane block, and 1(T3)and 8(T4)weeks after end of the treatment.Pain relief(PAR)was calculated by the formula: PAR=(VAS score before block--VAS score after block)/ VAS score before block × 100%.The morphine consumption and sleep quality were observed during the treatment and 1 week after treatment.Analgesic efficacy was graded 8 weeks after end of treatment.The effective rate and good response rate were calculated.Incidences of complications were recorded. \n \n \nResults \nThere was no significant difference in the VAS score between the two groups before treatment(t=0.419, P>0.05), while VAS scores after treatment were lower in the observation group than in the control group(t=17.925, 19.662, 12.580 and 13.987, respectively, P 0.05). After treatment, the total scores of McGill were lower in the observation group than in the control group(t=18.612, 20.135, 13.213 and 12.356, respectively, P 0.05). While after treatment, the morphine consumptions were decreased in the observation group versus in the control group(t=22.341, 16.758, 17.827, 15.541 respectively, P<0.05). No punctures of abdominal cavity, chest cavity, internal organs or blood vessels by mistake occurred. \n \n \nConclusions \nUltrasound-guided transversus abdominis plane block is effective and has less adverse reactions in treating herpetic neuralgia located in anterior abdominal wall. \n \n \nKey words: \nNeuromuscular blockade;\xa0Ultrasonography;\xa0Herpes zoster;\xa0Neuralgia