Jaipur block in postherpetic neuralgia

Background Postherpetic neuralgia, a common sequele to herpes zoster infection, is a chronic debilitating problem. The available therapeutic modalities are usually ineffective. Methods A total of 3960 patients (1326 women and 2634 men; age group, 21–84 years), with postherpetic neuralgia as the presenting complaint and with pain lasting from 2 months to 5 years, were treated with Jaipur block, consisting of local subcutaneous infiltration of 2% xylocaine, 0.5% bupivacaine, and 4 mg/mL dexamethasone solution. Patients were followed up at six-weekly intervals with subsequent injections given in non-responders. Results Twenty eight per cent of patients obtained complete relief from pain after a single injection, another 57% after a second injection, and 11% after a third injection; 4% of patients did not respond to treatment. The non-responders were either old (over 60 years) or had pain lasting for more than 2 years. The response to therapy was similar in both sexes. There were 31 left-handed patients in this study. Pain was less severe in left-handed patients and they obtained complete relief after a single injection. Side-effects including giddiness and sweating were seen, occasionally, in a few patients. Conclusions Ninety six per cent of patients obtained complete relief after the block with a follow-up of up to 19 years.