Case Reports: Zoster Pain in Haematological Malignancies: Effective Pain Relief with Oxycodone in Patients Unresponsive to Other Analgesic Measures

Authors: Niscola, Pasquale1; Perrotti, Alessio Pio1; del Poeta, Giovanni1; Romani, Claudio2; Palombi, Massimiliano1; Piccioni, Daniela1; Scaramucci, Laura1; Tolu, Barbara1; Tendas, Andrea1; Cupelli, Luca1; Abruzzese, Elisabetta1; D'Elia, Gianna Maria3; Brunetti, Gregorio Antonio3; Maurillo, Luca1; Giovannini, Marco4; Cartoni, Claudio3; de Fabritiis, Paolo1

Source: Herpes, Volume 14, Number 2, 2007 , pp. 45-47(3)

Publisher: Cambridge Medical Publications

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Abstract:

Varicella zoster virus (VZV) outbreak is a significant cause of morbidity in patients suffering from blood-related malignancies, occurring mostly among those affected by lymphoproliferative disorders and in those receiving haematopoietic stem-cell transplantation. The elucidated pathological mechanisms of VZV-related painful complications have provided the rationale for acute zoster pain (AZP) and post-herpetic neuralgia (PHN) treatment with antiviral therapy combined with neuroactive agents, such as tricyclic or anticonvulsant agents. The role of opioids in this setting is less clearly established. We successfully treated (with oxycodone) 12 consecutive patients suffering from AZP and long-lasting PHN resistant to several agents, including anticonvulsants and analgesics. Our experience is reported together with a brief overview of the management of these often distressing and intractable complications.

Keywords: HAEMATOLOGICAL MALIGNANCIES; LEUKAEMIA; NON-HODGKIN'S LYMPHOMAS; MULTIPLE MYELOMA; HAEMATOPOIETIC STEM-CELL TRANSPLANTATION; IMMUNOSUPPRESSION; PAIN; POST-HERPETIC NEURALGIA; OPIOIDS; OXYCODONE

Document Type: Case report

Affiliations: 1: Haematology Division, Sant'Eugenio Hospital, Tor Vergata University, Rome, Italy 2: Armando Businco Cancer Centre, Cagliari, Sardinia, Italy 3: Human Biopathology and Haematology Department, 'La Sapienza' University, Rome, Italy 4: Umberto I Hospital, Frosinone, Italy

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