INJECTION STREPTOMYCIN AND LIGNOCAINE COMBINATION FOR POSTHERPETIC NEURALGIA

Postherpetic Neuralgia

Abstract

The aim of this study was to determine the extent of pain relief achieved by combining
injections streptomycin with lignocaine for local infiltration or nerve block in the
treatment of postherpetic neuralgia. The study was a randomized, blinded, placebo
controlled clinical trial with twelve weeks of follow up period. It was carried out at skin
centre, Military Hospital, Rawalpindi. 40-70 years old sixty patients of either sex having
persistence or recurrence of pain more than one month after the onset of the eruption of
herpes zoster, with complete fallen off crusts, were selected for the study. Age, sex and
substance matched controls suffering from postherpetic neuralgia were randomly selected
as controls. Out of these selected patients 30 were given injections streptomycin –
lignocaine combination for nerve block while normal saline was infiltrated in rest of the
30, age, sex and site matched control patients. Intercostal, supraorbital, supratrochlear
and infraorbital nerves were blocked in different patients. For other nerves without
anatomical identification sites, local infiltration in the area of cutaneous nerves was done.
One gram of streptomycin was dissolved in 4ml of 2% plain lignocaine for each injection.
A total of 3 injections were given on alternate days. Pain assessment was done at different
intervals with visual analogue scale. At 12 weeks the mean pain reduction was more than
80%(P= .000). Excellent and good pain relief rating in treatment group was more than
96% (P= .000).The study suggests that the combination of injection streptomycinlignocaine
for local infiltration or nerve block is highly effective in relieving postherpetic
neuralgia without any side effect.