Objective

2

To investigate the therapeutic effect of subdural anesthesia with methylene blue injection on postherpetic neuralgia.

Methods

2

A total of 120 patients with postherpetic neuralgia (including 44 male and 76 female patients aged 45-80 years) receiving treatment in the Second Affiliated Hospital of Army Medical University between September

2017 and November

2018 were enrolled in this study. All the patients

including 50 with thoracic herpes zoster and 70 with lumbar herpes zoster

were randomized equally into 3 groups according to the time of admission for treatment with routine epidural block (group I)

epidural methylene blue injection in addition to routine epidural block (group Ⅱ)

or methylene blue injection + local injection of the conventional drugs (group Ⅲ). Visual analog scale (VAS) and Pittsburgh Sleep Quality Index (PSQI) were used for assessment of the patients before and after 1

2

3

and 4 weeks of treatment.

Results

2

The VAS and PSQI scores were were decreased significantly in all the 3 groups after the treatment (

P

<

0.05). After 4 weeks of treatment

VAS and PSQI scores differed significantly among the 3 groups

and the lowest scores were in group Ⅱ (

P

<

0.001).

Conclusion

2

The combination of subdural methylene blue injection and epidural block can significantly improve the treatment efficacy for postherpetic neuralgia

and can be used for treatment of refractory postherpetic neuralgia that fails to respond to conventional drug treatment.