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To determine the efficacy of methylcobalamin combined with lidocaine for acute herpetic neuralgia.
Methylcobalamin
(MeCbl) is the activated form of vitamin B12, has been used to treat some
nutritional diseases and other diseases in clinic, such as Alzheimer’s disease
and rheumatoid arthritis. B12 group of vitamins had been used to treat pain.
Lidocaine is a local anesthetic (numbing medication). This research draws
attention towards MeCbl combined with lidocaine which proved to have potential
analgesic effect in patients with herpetic neuralgia.
To determine the
efficacy of methylcobalamin combined with lidocaine for acute herpetic
neuralgia.
Design-
Randomized controlled trial with longitudinal analysis. Subjects. The authors
recruited 204 patients (>50 years) with T5-10 dermatomal acute herpetic
neuralgia with rash onset within 7 days. Patients were divided into two groups
based on the time of onset: immediate-early (IE, 1–3 days) and early stage (ES,
4–7 days) groups and then subdivided randomly into control (IE-Ctl, ES-Ctl) and
treatment (IE-Tr, ES-Tr) groups.
Control groups received intramuscular
methylcobalamin in addition to local lidocaine injection, while treatment
groups received local methylcobalamin combined with lidocaine injection for 14
days. Treatment efficacy was assessed based on rash healing time, alteration in
pain intensity, and interference with quality of life. Multilevel mixed
modeling and survival analysis were employed to examine treatment responses.
There was no
significant difference in the rash healing time between IE and ES. The mean
pain scores in IE-Tr (2.4 ± 0.7) and ES-Tr (1.3 ± 0.7) decreased significantly
compared with those in the control groups. The median satisfactory response
time was 6 days in ES-Tr and 11 days in IE-Tr. The benefit ratio for ES-Tr
versus IE-Tr was 14.94. The subjects in IE-Tr and ES-Tr had higher quality of
life scores (81.2 ± 6.9 vs 88.3 ± 8.6, respectively) than those in the control
groups. The incidence of post herpetic neuralgia was 1.1% at 3 months.
Local
methylcobalamin combined with lidocaine, optimally administered within 4–7 days
of onset, may be an effective therapeutic option for acute herpetic neuralgia.
Pain Medicine 2015;0: 1–10
Local Injection of Methylcobalamin Combined with Lidocaine for Acute Herpetic Neuralgia
Gang Xǔ et al.
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