RESUMO
Se realiza una revisión de los estados dolorosos en que tienen participación las vías simpáticas el sistema nervioso autónomo: en la mediación del dolor (dolor mediado por el simpático) o en la mantención de éste (dolor mantenido por el simpático), considerando la evidencia clínica y experimental con los bloqueos de las vías autonómicas en el control de este tipo de dolor. Se analiza la utilidad de estas técnicas en síndrome de dolor regional complejo tipo 1, herpes zoster y neuralgia post herpética, dolor de miembro fantasma y dolor visceral de origen oncológico.
It is carried out a revision of the painful states with participation of the sympathetic pathways of the autonomic nervous system: in the mediation of the pain (sympathetically mediated pain) or in the maintention of this (simpathetically maintained pain), considering the clinical and experimental evidence that indicate the beneficial effects with the interruption of autonomic pathways in the control of this type of pain. were analyzed this techniques in complex regional pain syndrome type 1, herpes zoster and post-herpetic neuralgia, phantom limb pain and visceral pain of oncology origin.
Assuntos
Humanos , Bloqueio Nervoso Autônomo/métodos , Medição da Dor/métodos , Distrofia Simpática Reflexa/tratamento farmacológico , Distrofia Simpática Reflexa/terapia , Sistema Nervoso Autônomo , Gânglio Estrelado , Neuralgia Pós-Herpética/tratamento farmacológico , Neuralgia Pós-Herpética/terapia , Plexo CelíacoRESUMO
BACKGROUND: Many investigators have advocated neural and especially regional sympathetic blockade for acute herpe. zoster pain. Some believe that nerve blocks not only relieve acute pain but also, if given early in the course of clinical disease, prevent progression to postherpetic neuralgia. OBJECTIVE: The purpose of this study was to evaluate the preventive effect of sympathetic blockade on herpes zoster METHODS: Fifteen patients with herpes zoster were treated with sympathetic blocks according to the severity of pain. RESULTS: The total score of pain degree decreased from 3.4 to 1.1 with sympathetic blocks in 15 patients in 2 months. Sympathetic blocks prevented or relieved postherpetic neuralgia in more than 90% of patients treated within 2 weeks of the onset of the acute phase of the disease and in more than 85% of patients over 60. CONCLUSION: Sympathetic blocks are effective in preventing postherpetic neuralgia if applied soon after the onset of the acute phase of herpes zoster.