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Ultrasound‐Guided Cervical Nerve Root Block for the Treatment of Acute Cervical Herpes Zoster: A Randomized Controlled Clinical Study
Author(s) -
Zheng Shuyue,
Li Xiuhua,
Yang Xiaohui,
He Liangliang,
Xue Yanyan,
Yang Zhanmin
Publication year - 2019
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12770
Subject(s) - medicine , placebo , analgesic , adverse effect , randomized controlled trial , incidence (geometry) , neuralgia , anesthesia , neuropathic pain , physics , alternative medicine , pathology , optics
Objectives To evaluate the efficacy and safety of ultrasound‐guided cervical nerve root block (CRB) on acute pain and its preventive effects on post‐herpetic neuralgia (PHN) in patients with cervical herpes zoster (HZ). Methods 140 recruited participants were randomized 1:1 to receive ultrasound‐guided CRB with either mixed drug liquid (treatment group) or similar looking placebo (placebo group). All patients received a 7‐day course of oral antiviral treatment, pregabalin, and analgesics as needed. The primary efficacy was assessed on the basis of HZ burden of illness (HZ‐BOI) scores over 30 days (BOI‐30 AUC ). Secondary outcomes included HZ‐BOI scores through 30 to 90 days (BOI‐30‐90 AUC ) and 90 to 180 days (BOI‐90‐180 AUC ), quality of life (QoL) outcomes, concomitant analgesic consumption, and the incidence of PHN. Adverse events were recorded to evaluate safety. Results The BOI‐30 AUC values were 92.55 and 112.72 for the treatment and placebo groups, respectively ( P < 0.01). Both the BOI‐30‐90 AUC and BOI‐90‐180 AUC in the treatment group were lower than those in the placebo group ( P < 0.01). The incidence of PHN at 90 days was significantly less than that at 180 days in the treatment group ( P = 0.036). A better improvement in QoL was found in the treatment group ( P < 0.05). There was a greater decrease in analgesic use in the treatment group as compared to the placebo group ( P < 0.05). No serious adverse events were observed. Conclusions Ultrasound‐guided CRB represented an early intervention and preventive strategy to reduce the BOI due to acute HZ in the cervical dermatome region, and might be feasible to reduce the incidence of PHN.