Such interventions would have the potential to reduce the prevalence of chronic pain in the population .
Although certain risk factors can identify individuals who are most likely to develop chronic pain , few interventions to prevent chronic pain have been identified .
To facilitate the identification of preventive interventions , an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain .
We present general design considerations for prevention trials in population s that are at relatively high risk for developing chronic pain .
The Effectiveness of Repetitive Paravertebral Injections with Local Anesthetics and Steroids for the Prevention of Postherpetic Neuralgia in Patients with Acute Herpes Zoster
BACKGROUND : The treatment of postherpetic neuralgia ( PHN ) continues to be a challenge in clinical pain management . In this r and omized , controlled study , we assessed the effectiveness of repetitive paravertebral injections with local anesthetics and steroids for the prevention of PHN in patients with acute herpes zoster . METHODS : One hundred thirty-two patients with acute herpes zoster diagnosed 1–7 days after the onset of the rash were r and omly assigned to receive either st and ard therapy ( oral antivirals and analgesics ) or st and ard therapy with additional repetitive paravertebral injections of a mixture of 10 mL 0.25 % bupivacaine and 40 mg methylprednisolone acetate every 48 h for a week . Efficacy was evaluated at 1 , 3 , 6 , and 12 mo after the end of the treatments . The primary end point was the proportion of patients with zoster-associated pain and /or allodynia 1 mo after inclusion . Statistical analysis was performed based on the intent-to-treat population . RESULTS : One hundred thirteen patients completed the 1-yr follow-up . At 1 mo posttherapy , 13 % of patients in the paravertebral group reported zoster-related pain , compared with 45 % in the st and ard group ( P < 0.001 ) . At 3 , 6 , and 12 mo posttherapy , the incidence of PHN was still significantly lower in the paravertebral group than in the st and ard group . The quality of life improved in both groups at each follow-up time point with no significant difference between groups . CONCLUSION : Repetitive paravertebral anesthetic block in combination with steroids plus st and ard treatment with acyclovir and analgesics significantly reduced the incidence of PHN than the st and ard treatment alone
Such interventions would have the potential to reduce the prevalence of chronic pain in the population .
Although certain risk factors can identify individuals who are most likely to develop chronic pain , few interventions to prevent chronic pain have been identified .
To facilitate the identification of preventive interventions , an IMMPACT meeting was convened to discuss research design considerations for clinical trials investigating the prevention of chronic pain .
We present general design considerations for prevention trials in population s that are at relatively high risk for developing chronic pain .