Postherpetic Neuralgia: Current Evidence on the Topical Film-Forming Spray with Bupivacaine Hydrochloride and a Review o
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REVIEW
Postherpetic Neuralgia: Current Evidence on the Topical Film-Forming Spray with Bupivacaine Hydrochloride and a Review of Available Treatment Strategies Anh L. Ngo . Ivan Urits . Melis Yilmaz . Luc Fortier . Anthony Anya . Jae Hak Oh . Amnon A. Berger . Hisham Kassem . Manuel G. Sanchez . Alan D. Kaye . Richard D. Urman . Edwin W. Herron . Elyse M. Cornett . Omar Viswanath
Received: February 12, 2020 Ó The Author(s) 2020
ABSTRACT Purpose of Review: This is a comprehensive review of the literature about the use of bupivacaine hydrochloride for the treatment of post-herpetic neuralgia (PHN). It briefly reviews the background, biology, diagnosis and conventional treatment for PHN, and then intro-
duces and compares the recent evidence for the use of topical bupivacaine. Recent Findings: PHN is defined by pain lasting 90 days or more after the initial presentation of herpes zoster (‘‘Shingles’’, HZ) rash and is the most common complication of this disease. A product of re-activation of the Varicella-Zoster virus (VZV), HZ is diagnosed more than 1 million times annually in the United States. Approximately 20% of patients with HZ will experience PHN and will continue to suffer intermittent neuropathic symptoms, including
Enhanced Digital Features To view enhanced digital features for this article go to https://doi.org/10.6084/ m9.figshare.12040533. A. L. Ngo M. Yilmaz Harvard Medical School, Boston, MA, USA A. L. Ngo A. A. Berger M. G. Sanchez Department of Pain Medicine, Pain Specialty Group, Newington, NH, USA I. Urits (&) Department of Anesthesiology, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA e-mail: [email protected] L. Fortier A. Anya J. H. Oh Georgetown University School of Medicine, Washington, DC, USA H. Kassem Department of Anesthesiology, Mount Sinai Medical Center, Miami Beach, FL, USA
A. D. Kaye E. W. Herron E. M. Cornett Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA, USA R. D. Urman Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, USA O. Viswanath Valley Anesthesiology and Pain Consultants, Envision Physician Services, Phoenix, AZ, USA O. Viswanath Department of Anesthesiology, University of Arizona College of Medicine Phoenix, Phoenix, AZ, USA O. Viswanath Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA
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itching and pain, that is sharp, stabbing, throbbing or burning, with the pain localized to the site of their original rash. This long-lasting pain compares with the severity of long-standing rheumatics and osteo-arthritis and is accompanied by severe allodynia causing significant suffering, and a financial burden that is manifested in both healthcare costs and loss of quality-adjusted life years. Prevention of PHN may be achieved with the Zoster vaccine, although there is still a large segment of unvaccinated population. Moreover, the Zoster vaccine is not alway
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