Serial stellate ganglion blocks for intractable postherpetic itching in a pediatric patient: A case report Journal Article
| Authors: | Peterson, R. C.; Patel, L.; Cubert, K.; Gulati, A. |
| Article Title: | Serial stellate ganglion blocks for intractable postherpetic itching in a pediatric patient: A case report |
| Abstract: | Background: While intractable itching may be rarely associated with postherpetic neuralgia, it can have catastrophic complications if present. Method: We highlight a severe case of postherpetic itching in a 10-year-old male with Fanconi's and aplastic anemia, refractory to conventional treatments and requiring intravenous sedation. Results: Our use of 3 sequential stellate ganglion blocks with 5.5 mL of 0.25% bupivacaine provided significant improvement of the symptoms for 4 months after the last procedure. Conclusion: Although further evaluation is needed, we feel that novel use of sympathetic blockade may provide treatment for intractable itching. Highlighted is the possible influence of the sympathetic system in the pathophysiology of postherpetic itch. Implication: The use of serial stellate ganglion blocks may be a treatment option for patients with intractable itching and postherpertic neuralgia of the neck and arm region. This technique may lead to more permanent solutions such as pulse radiofrequency lesion or chemical neurolysis of sympathetic ganglions for postherpetic itch. |
| Keywords: | child; treatment outcome; antibiotic agent; case report; pathophysiology; methodology; pain; lorazepam; opiate; sedation; antifungal agent; herpes zoster; drug effect; histology; physiology; pediatric; virology; pruritus; skin; immunology; narcotic analgesic agent; disease severity; sensory nerve; sensory receptor cells; ondansetron; skin disease; antivirus agent; lidocaine; immune deficiency; immunocompromised host; anticonvulsive agent; bone marrow transplantation; bupivacaine; innervation; analgesic agent; opportunistic infections; aplastic anemia; pain, intractable; antihistaminic agent; opportunistic infection; fentanyl; nerve block; cellulitis; anesthesiological techniques; intractable itching; postherpetic itch; stellate; benzodiazepine; tricyclic antidepressant agent; fanconi anemia; miosis; ptosis; stellate ganglion block; automutilation; intractable pain; postherpetic neuralgia; sensory receptor; stellate ganglion; afferent pathways; autonomic nerve block; neuralgia, postherpetic; scalp dermatoses; self mutilation |
| Journal Title: | Pain Physician |
| Volume: | 12 |
| Issue: | 3 |
| ISSN: | 1533-3159 |
| Publisher: | American Society of Interventional Pain Physicians |
| Date Published: | 2009-05-01 |
| Start Page: | 629 |
| End Page: | 632 |
| Language: | English |
| PUBMED: | 19461828 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 1" - "Export Date: 30 November 2010" - "CODEN: PPAHA" - "Source: Scopus" |
