Peripheral nerve block with a high concentration of tetracaine dissolved in bupivacaine for intractable post-herpetic itch: a case report
Abstract Background Post-herpetic itch (PHI) is a neuropathic itch syndrome following herpes zoster. It has been reported that PHI is occasionally sufficiently severe to compromise patients’ quality of life and frequently refractory to treatment. Here, we present a case of severe chronic PHI success...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2016-12-01
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| Series: | JA Clinical Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40981-016-0069-y |
| _version_ | 1819181121657634816 |
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| author | Daiki Yamanaka Takashi Kawano Marie Shigematsu-Locatelli Atsushi Nishigaki Sonoe Kitamura Bun Aoyama Hiroki Tateiwa Noriko Kitaoka Masataka Yokoyama |
| author_facet | Daiki Yamanaka Takashi Kawano Marie Shigematsu-Locatelli Atsushi Nishigaki Sonoe Kitamura Bun Aoyama Hiroki Tateiwa Noriko Kitaoka Masataka Yokoyama |
| author_sort | Daiki Yamanaka |
| collection | DOAJ |
| description | Abstract Background Post-herpetic itch (PHI) is a neuropathic itch syndrome following herpes zoster. It has been reported that PHI is occasionally sufficiently severe to compromise patients’ quality of life and frequently refractory to treatment. Here, we present a case of severe chronic PHI successfully treated with supraorbital nerve block using a high concentration of tetracaine dissolved in bupivacaine. Case presentation An 82-year-old man presented with severe chronic itching in the ophthalmic branch of the left trigeminal nerve dermatome, following acute herpes zoster. The patient’s itching was unresponsive to usual medical treatments for PHI including antiepileptic drugs, topical capsaicin cream, and supraorbital nerve radiofrequency thermo-coagulation. Topical lidocaine cream could relieve the itching, but could not provide long-term relief of itching and thus failed to achieve a satisfactory result. After these conventional treatments, left supraorbital nerve block using 4% tetracaine dissolved with 0.5% bupivacaine was conducted. Afterwards, the patient experienced long-lasting resolution of the itching with improvement of sleep disturbance. A transient, mild edema of the eyelids occurred, but there were no other complications. Conclusions Peripheral nerve block using 4% tetracaine dissolved with 0.5% bupivacaine was beneficial in relieving PHI in the ophthalmic division of the trigeminal nerve. |
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| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2363-9024 |
| language | English |
| last_indexed | 2024-12-22T22:25:12Z |
| publishDate | 2016-12-01 |
| publisher | SpringerOpen |
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| series | JA Clinical Reports |
| spelling | doaj.art-8a659373bdcf418980299db20c6e1cea2022-12-21T18:10:35ZengSpringerOpenJA Clinical Reports2363-90242016-12-01211410.1186/s40981-016-0069-yPeripheral nerve block with a high concentration of tetracaine dissolved in bupivacaine for intractable post-herpetic itch: a case reportDaiki Yamanaka0Takashi Kawano1Marie Shigematsu-Locatelli2Atsushi Nishigaki3Sonoe Kitamura4Bun Aoyama5Hiroki Tateiwa6Noriko Kitaoka7Masataka Yokoyama8Department of Anesthesiology and Intensive Care Medicine, Kochi Medical SchoolDepartment of Anesthesiology and Intensive Care Medicine, Kochi Medical SchoolDepartment of Anesthesiology and Intensive Care Medicine, Kochi Medical SchoolDepartment of Anesthesiology and Intensive Care Medicine, Kochi Medical SchoolDepartment of Anesthesiology and Intensive Care Medicine, Kochi Medical SchoolDepartment of Anesthesiology and Intensive Care Medicine, Kochi Medical SchoolDepartment of Anesthesiology and Intensive Care Medicine, Kochi Medical SchoolDepartment of Anesthesiology and Intensive Care Medicine, Kochi Medical SchoolDepartment of Anesthesiology and Intensive Care Medicine, Kochi Medical SchoolAbstract Background Post-herpetic itch (PHI) is a neuropathic itch syndrome following herpes zoster. It has been reported that PHI is occasionally sufficiently severe to compromise patients’ quality of life and frequently refractory to treatment. Here, we present a case of severe chronic PHI successfully treated with supraorbital nerve block using a high concentration of tetracaine dissolved in bupivacaine. Case presentation An 82-year-old man presented with severe chronic itching in the ophthalmic branch of the left trigeminal nerve dermatome, following acute herpes zoster. The patient’s itching was unresponsive to usual medical treatments for PHI including antiepileptic drugs, topical capsaicin cream, and supraorbital nerve radiofrequency thermo-coagulation. Topical lidocaine cream could relieve the itching, but could not provide long-term relief of itching and thus failed to achieve a satisfactory result. After these conventional treatments, left supraorbital nerve block using 4% tetracaine dissolved with 0.5% bupivacaine was conducted. Afterwards, the patient experienced long-lasting resolution of the itching with improvement of sleep disturbance. A transient, mild edema of the eyelids occurred, but there were no other complications. Conclusions Peripheral nerve block using 4% tetracaine dissolved with 0.5% bupivacaine was beneficial in relieving PHI in the ophthalmic division of the trigeminal nerve.http://link.springer.com/article/10.1186/s40981-016-0069-yPost-herpetic itchPeripheral nerve blockTetracaine |
| spellingShingle | Daiki Yamanaka Takashi Kawano Marie Shigematsu-Locatelli Atsushi Nishigaki Sonoe Kitamura Bun Aoyama Hiroki Tateiwa Noriko Kitaoka Masataka Yokoyama Peripheral nerve block with a high concentration of tetracaine dissolved in bupivacaine for intractable post-herpetic itch: a case report JA Clinical Reports Post-herpetic itch Peripheral nerve block Tetracaine |
| title | Peripheral nerve block with a high concentration of tetracaine dissolved in bupivacaine for intractable post-herpetic itch: a case report |
| title_full | Peripheral nerve block with a high concentration of tetracaine dissolved in bupivacaine for intractable post-herpetic itch: a case report |
| title_fullStr | Peripheral nerve block with a high concentration of tetracaine dissolved in bupivacaine for intractable post-herpetic itch: a case report |
| title_full_unstemmed | Peripheral nerve block with a high concentration of tetracaine dissolved in bupivacaine for intractable post-herpetic itch: a case report |
| title_short | Peripheral nerve block with a high concentration of tetracaine dissolved in bupivacaine for intractable post-herpetic itch: a case report |
| title_sort | peripheral nerve block with a high concentration of tetracaine dissolved in bupivacaine for intractable post herpetic itch a case report |
| topic | Post-herpetic itch Peripheral nerve block Tetracaine |
| url | http://link.springer.com/article/10.1186/s40981-016-0069-y |
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