Tao JC, Huang B, Luo G, Zhang ZQ, Xin BY, Yao M. Trigeminal extracranial thermocoagulation along with patient-controlled analgesia with esketamine for refractory postherpetic neuralgia after herpes zoster ophthalmicus: A case report. World J Clin Cases 2022; 10(13): 4220-4225 [PMID: 35665100 DOI: 10.12998/wjcc.v10.i13.4220]
Corresponding Author of This Article
Ming Yao, PhD, Professor, Department of Anesthesiology and Pain Medicine, The Affiliated Hospital of Jiaxing University, No. 1882 Zhong Huan South Road, Jiaxing 314000, Zhejiang Province, China. jxyaoming666@163.com
Research Domain of This Article
Neurosciences
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 6, 2022; 10(13): 4220-4225 Published online May 6, 2022. doi: 10.12998/wjcc.v10.i13.4220
Trigeminal extracranial thermocoagulation along with patient-controlled analgesia with esketamine for refractory postherpetic neuralgia after herpes zoster ophthalmicus: A case report
Jia-Chun Tao, Bing Huang, Ge Luo, Zhi-Qiang Zhang, Bing-Yue Xin, Ming Yao
Jia-Chun Tao, Bing Huang, Ge Luo, Zhi-Qiang Zhang, Bing-Yue Xin, Ming Yao, Department of Anesthesiology and Pain Medicine, The Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
Author contributions: Tao JC performed the literature research and drafted the manuscript; Xin BY and Zhang ZQ collected the data; Luo G analyzed the data Huang B and Yao M conceived the study design and revised the manuscript in depth; All authors have read and approved final version of this manuscript for publication.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: All the authors have read the CARE Checklist (2016), and the manuscript was revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ming Yao, PhD, Professor, Department of Anesthesiology and Pain Medicine, The Affiliated Hospital of Jiaxing University, No. 1882 Zhong Huan South Road, Jiaxing 314000, Zhejiang Province, China. jxyaoming666@163.com
Received: September 12, 2021 Peer-review started: September 12, 2021 First decision: February 14, 2022 Revised: February 23, 2022 Accepted: March 15, 2022 Article in press: March 15, 2022 Published online: May 6, 2022 Processing time: 229 Days and 14.7 Hours
Abstract
BACKGROUND
Primary trigeminal neuralgia can achieve satisfactory results through clinical treatment and intervention. The pathogenesis of neuralgia caused by varicella-zoster virus infection of the trigeminal nerve is more complex, and it is still difficult to relieve the pain in some patients simply by drug treatment or surgical intervention.
CASE SUMMARY
A 66-year-old woman was hospitalized with herpetic neuralgia after herpes zoster ophthalmicus (varicella-zoster virus infects the ophthalmic branch of the trigeminal nerve). On admission, the patient showed spontaneous, electric shock-like and acupuncture-like severe pain in the left frontal parietal region, and pain could be induced by touching the herpes area. The numerical rating scale (NRS) was 9. There was no significant pain relief after pulsed radiofrequency and thermocoagulation of the ophthalmic branch of the trigeminal nerve. Combined with patient-controlled intravenous analgesia (PCIA) with esketamine, neuralgia was significantly improved. The patient had no spontaneous pain or allodynia at discharge, and the NRS score decreased to 2 points. The results of follow-up 2 mo after discharge showed that the NRS score was ≤ 3, and the Pittsburgh Sleep Quality Index score was 5 points. There were no adverse reactions.
CONCLUSION
Trigeminal extracranial thermocoagulation combined with esketamine PCIA may be a feasible method for the treatment of refractory herpetic neuralgia after herpes zoster ophthalmicus.
Core Tip: We applied thermocoagulation combined with esketamine intravenous controlled analgesia for the first time in the treatment of refractory herpetic neuralgia after herpes zoster ophthalmicus.
