The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Intravenous patient-controlled analgesia hydromorphone combined with pregabalin for the treatment of postherpetic neuralgia: a multicenter, randomized controlled study

  • Huang, Ying (Department of Pain, Drum Tower Hospital, Medical School of Nanjing University) ;
  • Xu, Chenjie (Department of Anesthesiology and Pain, Nanjing First Hospital, Nanjing Medical University) ;
  • Zeng, Tao (Department of Pain, Kunshan Hospital of Integrated Traditional Chinese and Western Medicine) ;
  • Li, Zhongming (Department of Pain, Affiliated Hospital of Nantong University) ;
  • Xia, Yanzhi (Department of Anesthesiology, Shanghai Public Health Clinical Center, Fudan University) ;
  • Tao, Gaojian (Department of Pain, Drum Tower Hospital, Medical School of Nanjing University) ;
  • Zhu, Tong (Department of Pain, Drum Tower Hospital, Medical School of Nanjing University) ;
  • Lu, Lijuan (Department of Pain, Drum Tower Hospital, Medical School of Nanjing University) ;
  • Li, Jing (Department of Pain, Drum Tower Hospital, Medical School of Nanjing University) ;
  • Huang, Taiyuan (Department of Pain, Drum Tower Hospital, Medical School of Nanjing University) ;
  • Huai, Hongbo (Department of Pain, Drum Tower Hospital, Medical School of Nanjing University) ;
  • Ning, Benxiang (Department of Pain, Drum Tower Hospital, Medical School of Nanjing University) ;
  • Ma, Chao (Department of Pain, Drum Tower Hospital, Medical School of Nanjing University) ;
  • Wang, Xinxing (Department of Pain Medicine, China-Japan Friendship Hospital) ;
  • Chang, Yuhua (Department of Pain, Bayingolin Mongolian Autonomous Prefecture People's Hospital) ;
  • Mao, Peng (Department of Pain Medicine, China-Japan Friendship Hospital) ;
  • Lin, Jian (Department of Pain, Drum Tower Hospital, Medical School of Nanjing University)
  • Received : 2020.10.20
  • Accepted : 2020.12.28
  • Published : 2021.04.01
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Abstract

Background: Postherpetic neuralgia (PHN) is the most common complication of acute herpes zoster. The treatment of PHN remains a challenge for clinical pain management. Despite the effectiveness of anticonvulsants, antidepressants, and lidocaine patches in reducing PHN, many patients still face intractable pain disorders. In this randomized controlled study, we evaluated whether hydromorphone through intravenous patient-controlled analgesia (IV PCA) was effective in relieving PHN. Methods: Patients with PHN were randomly divided into two groups, one group received oral pregabalin with IV normal saline, another group received oral pregabalin with additional IV PCA hydromorphone for two weeks. Efficacy was evaluated at 1, 4, and 12 weeks after the end of the treatments. Results: Two hundred and one patients were followed up for 12 weeks. After treatment, numerical rating scale (NRS) score of patients in the hydromorphone group was significantly lower than that of the control group, and the difference of NRS scores between the two groups was statistically significant at 4 and 12 weeks after treatment. The frequency of breakthrough pain in the hydromorphone group was significantly lower than that in the control group 1 and 4 weeks after treatment. After treatment, the quality of sleep in the hydromorphone group was significantly improved compared with the control group. The most common adverse reactions in the hydromorphone group were dizziness and nausea, with no significant respiratory depression. Conclusions: IV PCA hydromorphone combined with oral pregabalin provides superior pain relief in patients with PHN, which is worthy of clinical application and promotion.

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References

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