Acute Herpes Zoster Neuropathy
Conditions
Brief summary
Acute herpes zoster pain is very severe . Conventional analgesics may be of no value. Regional blocks may play a role
Interventions
PROCEDUREultrasound guided erector spine block
Ultrasound guided thoracic erector spinae block
PROCEDURESerratus anterior block
Ultrasound guided serratus anterior block
Sponsors
Minia University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
30 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Adult population between 30 and 75 years old. * Unilateral painful thoracic herpetic eruption of less than one week duration. * VAS more than or equal 4, persistent pain in spite of proper antiviral and analgesic therapy, (800 mg oral acyclovir, 5 times per day, for one week), pregabalin 300 mg per day, acetaminophen 1000 mg per day, topical calamine lotion).
Exclusion criteria
* Diabetic patients. * Painful herpetic eruptive vesicles more than one week. * Abdominal herpetic eruptions. * Non-compliant on anti-viral (bulbar palsy for example). * Co-malignancy or radiotherapy. * Steroid therapy \> 5 mg prednisolone or its equivalent. * Infections or hematoma at site of injection. * Coagulopathy (chronic kidney or liver disease, clopidogrel use).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| pain score | immediate after injection, 1 week, 1, 3 months | Visual analogue scale from 0 to 10. 0= NO pain, 1-3=mild tolerable pain, 4-6= moderate pain, 7-10= severe untearable pain. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of treatment related adverse events | immediately after injection | hypotension, bradyarrhythmia, hematoma |
| Number of patients with pain recurrence | 1 week, 1, and 3 months | Number of patients in need for re-injection |
| analgesic consumption | 1 week, 1, and 3 months | total amount dose of analgesics used |
Outcome results
None listed