Temporary spinal cord stimulation combined with lidocaine patch for postherpetic neuralgia in the elderly: a controlled study
BackgroundPostherpetic neuralgia (PHN) is a chronic neuropathic pain condition in elderly patients following herpes zoster infection. Conventional treatments often have inconsistent efficacy and significant side effects. Combining spinal cord stimulation (SCS) with lidocaine patches may enhance pain...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1529673/full |
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| author | Yun Li Chunhui Hao Shengtao Wang Feng Qiu Xuli Zhao Tao Sun |
| author_facet | Yun Li Chunhui Hao Shengtao Wang Feng Qiu Xuli Zhao Tao Sun |
| author_sort | Yun Li |
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| description | BackgroundPostherpetic neuralgia (PHN) is a chronic neuropathic pain condition in elderly patients following herpes zoster infection. Conventional treatments often have inconsistent efficacy and significant side effects. Combining spinal cord stimulation (SCS) with lidocaine patches may enhance pain relief by targeting central and peripheral pain mechanisms.MethodsThis randomized, controlled, single-blind trial enrolled 97 patients aged ≥60 years with PHN lasting ≥6 months. Participants were assigned to SCS with a 5% lidocaine patch (n = 49) or SCS with a placebo patch (n = 48). Both groups received oral pregabalin. The placebo patch was identical in appearance to ensure blinding. Pain intensity (VAS) and sleep quality (PSQI) were assessed at baseline and on days 1, 3, 7, 30, and 90 post-interventions. Subgroup analyses by age and PHN duration were conducted.ResultsAt day 90, the experimental group had greater reductions in VAS scores (1.6 ± 1.1) than the control group (2.7 ± 1.3, p < 0.01). Clinically significant pain relief (≥50% VAS reduction) was achieved by 72.3% in the experimental group versus 45.8% in the control group (p = 0.038). PSQI scores improved more in the experimental group (5.3 ± 2.1) than in the control group (8.2 ± 2.7, p = 0.021). Patients with PHN duration <60 days benefited more from combination therapy. Adverse events were minimal and similar between groups.ConclusionCombining SCS with lidocaine patches significantly enhances pain relief and sleep quality in elderly PHN patients compared to SCS alone. Further multicenter studies are recommended to validate these findings and assess long-term outcomes.Clinical trial registrationhttps://www.chictr.org.cn/searchprojEN.html, ChiCTR2000039059. |
| format | Article |
| id | doaj-art-049674dd8b6b4b87a1d61ce30018a853 |
| institution | Kabale University |
| issn | 1664-2295 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj-art-049674dd8b6b4b87a1d61ce30018a8532025-01-29T14:57:24ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-01-011610.3389/fneur.2025.15296731529673Temporary spinal cord stimulation combined with lidocaine patch for postherpetic neuralgia in the elderly: a controlled studyYun Li0Chunhui Hao1Shengtao Wang2Feng Qiu3Xuli Zhao4Tao Sun5Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaJinan Second Maternal and Child Health Hospital, Jinan, ChinaShandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaShandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaShandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaShandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, ChinaBackgroundPostherpetic neuralgia (PHN) is a chronic neuropathic pain condition in elderly patients following herpes zoster infection. Conventional treatments often have inconsistent efficacy and significant side effects. Combining spinal cord stimulation (SCS) with lidocaine patches may enhance pain relief by targeting central and peripheral pain mechanisms.MethodsThis randomized, controlled, single-blind trial enrolled 97 patients aged ≥60 years with PHN lasting ≥6 months. Participants were assigned to SCS with a 5% lidocaine patch (n = 49) or SCS with a placebo patch (n = 48). Both groups received oral pregabalin. The placebo patch was identical in appearance to ensure blinding. Pain intensity (VAS) and sleep quality (PSQI) were assessed at baseline and on days 1, 3, 7, 30, and 90 post-interventions. Subgroup analyses by age and PHN duration were conducted.ResultsAt day 90, the experimental group had greater reductions in VAS scores (1.6 ± 1.1) than the control group (2.7 ± 1.3, p < 0.01). Clinically significant pain relief (≥50% VAS reduction) was achieved by 72.3% in the experimental group versus 45.8% in the control group (p = 0.038). PSQI scores improved more in the experimental group (5.3 ± 2.1) than in the control group (8.2 ± 2.7, p = 0.021). Patients with PHN duration <60 days benefited more from combination therapy. Adverse events were minimal and similar between groups.ConclusionCombining SCS with lidocaine patches significantly enhances pain relief and sleep quality in elderly PHN patients compared to SCS alone. Further multicenter studies are recommended to validate these findings and assess long-term outcomes.Clinical trial registrationhttps://www.chictr.org.cn/searchprojEN.html, ChiCTR2000039059.https://www.frontiersin.org/articles/10.3389/fneur.2025.1529673/fullpostherpetic neuralgiaspinal cord stimulationlidocaine patchelderly patientspain management |
| spellingShingle | Yun Li Chunhui Hao Shengtao Wang Feng Qiu Xuli Zhao Tao Sun Temporary spinal cord stimulation combined with lidocaine patch for postherpetic neuralgia in the elderly: a controlled study Frontiers in Neurology postherpetic neuralgia spinal cord stimulation lidocaine patch elderly patients pain management |
| title | Temporary spinal cord stimulation combined with lidocaine patch for postherpetic neuralgia in the elderly: a controlled study |
| title_full | Temporary spinal cord stimulation combined with lidocaine patch for postherpetic neuralgia in the elderly: a controlled study |
| title_fullStr | Temporary spinal cord stimulation combined with lidocaine patch for postherpetic neuralgia in the elderly: a controlled study |
| title_full_unstemmed | Temporary spinal cord stimulation combined with lidocaine patch for postherpetic neuralgia in the elderly: a controlled study |
| title_short | Temporary spinal cord stimulation combined with lidocaine patch for postherpetic neuralgia in the elderly: a controlled study |
| title_sort | temporary spinal cord stimulation combined with lidocaine patch for postherpetic neuralgia in the elderly a controlled study |
| topic | postherpetic neuralgia spinal cord stimulation lidocaine patch elderly patients pain management |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1529673/full |
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