Diagnostic implications of primary amenorrhea. Combined clinical staff conference at the National Institutes of Health.
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Biomedical subjects
Publications and source records attributed to R Hertz.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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BACKGROUND AND OBJECTIVES: Herpes zoster infection in elderly patients frequently results in disabling pain, carries a high risk of postherpetic neuralgia (PHN), and can pose a significant therapeutic challenge. METHODS: We describe a successful use of the perivascular technique of lumbar plexus blockade ("three-in-one block") for treatment of pain during acute herpes zoster infection in an 82-year-old severely ill patient in whom other modalities were contraindicated. RESULTS: Three-in-one block using 40 mL of 0.25% bupivacaine with 1:300,000 epinephrine resulted in excellent pain relief that lasted for 2 weeks. CONCLUSIONS: The perivascular technique of lumbar plexus blockade may be a useful alternative to epidural and paravertebral techniques of lumbar blockade in the occasional patient for whom these other approaches are contraindicated.