Abstract
Postherpetic neuralgia can safely be prevented by administration of sympathetic nerve blocks during the first days of the disease.
In patients under anticoagulant therapy or poor-risk-patients these anaesthesiological methods cannot be applicated.
In these patients we prefer "electric blockades" following the techniques published by JENKNER.
Electric stellate ganglion blocks are indicated, when we find cranial, cervical or upper thoracic localisation of herpes zoster.
To improve the efficiency, we use the Ramp-Impulse-TENS, published 1985 (Jungck).
R-Tens is characerized by
- no painful stimulation at high output (up to 112 V and 400 mA ), - rise time less than 0, 5 μsec, - low output impedance (109, 5 Ohm), - no direct current.
The electric blockades were followed by increase of skin temperature (0, 8 - 2, 3 °C), often by HORNER’s syndrome.
Pain reduction was sufficient. Postherpetic neuralgia was not been observed in 18 patients.
Electric stellate ganglion blocks can be recommended, when anaesthesiologic blocks cannot be applicated.
The efficiency can be improved by the use of the Ramp-Impulse- TENS.
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