Interpleural analgesia in the treatment of severe thoracic postherpetic neuralgia.

Effective, long-lasting pain relief was produced in 26 patients suffering from severe thoracic postherpetic neuralgia by intermittent administration of local anesthetics into the pleural space through a percutaneously placed interpleural catheter. The duration of treatment varied from seven to 21 days. During this period, 30 ml of 0.5% bupivacaine with epinephrine (5 micrograms/ml) were injected every 24 hours. The injections were continued for three days after the patients were pain free or had reached an analgesic plateau. All patients achieved good to excellent pain relief. During a follow-up period of five to 15 months, their level of pain has not increased from the level achieved at the end of the treatment program.