THE 3-IN-ONE BLOCK FOR TREATMENT OF PAIN IN A PATIENT WITH ACUTE HERPES-ZOSTER INFECTION

Background and Objectives. Herpes tester infection in elderly patients frequently results in disabling pain, carries a high risk of postherp etic 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 pa in during acute herpes tester 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 epinephr ine resulted in excellent pain relief that lasted for 2 weeks. Conclus ions. The perivascular technique of lumbar plexus blockade may be a us eful alternative to epidural and paravertebral techniques of lumbar bl ockade in the occasional patient for whom these other approaches are c ontraindicated.