Retrospective evaluation of medical analgesictreatments applied to patients with acute herpes zosterneuralgia and postherpetic neuralgia referred to ourpain clinic between 2003-2023

Aim: The aim of the study was to investigate the effects of medical analgesics applied in patients with Acute Herpetic Neuralgia (AHN) and Postherpetic Neuralgia (PHN) admitted to the outpatient clinic of the Department of Anesthesiology and Reanimation, Division of Algology, between January 1, 2003, and December 31, 2023. Based on over 20 years of clinical experience, we assessed the effectiveness of our treatments and aimed to determine optimal treatment strategies with minimal side effects. By evaluating treatment protocols in different patient subgroups, we sought to compare the efficacy of individual drugs as well as their combinations. Methods and Materials: With the approval of the ethics committee, the files of patients diagnosed with Acute Herpetic Neuralgia (AHN) and Postherpetic Neuralgia (PHN) admitted to our outpatient clinic of Karadeniz Technical University Faculty of Medicine, Department of Anesthesiology and Reanimation, Division of Algology between 01.01.2003 and 31.12.2023 were retrospectively evaluated. Age and gender information, lesion localization, dermatomal distribution, accompanying malignancies, complications and treatment options, pain values at presentation to our clinic and pain values after treatment, medications used and their effects on pain were recorded in 425 patients. Results: The study included 425 patients diagnosed with Acute Herpetic Neuralgia (AHN) and Postherpetic Neuralgia (PHN) who were admitted to the Algology Outpatient Clinic of the Department of Anesthesiology and Reanimation, Karadeniz Technical University Faculty of Medicine between 01.01.2003 and 31.12.2023. Most patients presented with neuropathic pain symptoms. These symptoms were predominantly managed successfully with gabapentinoids (gabapentin, pregabalin). Additionally, weak opioids and NSAIDs, when added to gabapentinoids as needed, were also found to be effective in pain management. Conclusions: In general, our study demonstrates that treatment with anticonvulsant gabapentinoids such as gabapentin and pregabalin, especially in combination with nonsteroidal anti-inflammatory drugs and weak opioids, is effective in the management of pain in Acute Herpes Zoster neuralgia and Postherpetic Neuralgia. These findings are consistent with other studies in the literature and emphasize the importance of tailoring treatment approaches according to the individual characteristics of the patient.