Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Tanta University, Egypt.
Pain Physician. 2022 Aug;25(5):365-372.
The best tool for management of postherpetic neuralgia (PHN) is a matter of debate. The use of ultrasound-guided erector spinae plane block (ESPB) in patients with PHN may decrease pain severity and the need for analgesics.
The objective of this clinical study was to test the efficacy of ESPB with and without the addition of magnesium sulphate on pain control and analgesic consumption in patients with PHN.
Randomized controlled double-blinded trial.
A single university center.
A total of 75 patients with PHN were included in the study. Patients were randomly divided into 3 equal groups. Group A received sham ESPB (2 mL normal saline), Group B received ESPB with 20 mL of bupivacaine (0.25%), and Group C received ESPB with 20 mL of bupivacaine (0.25%) and 100 mg magnesium sulphate. All patients received standard medical care. The pain score, the consumption of pregabalin and acetaminophen, the incidence of complications, and the patient's satisfaction were measured and recorded.
In comparison to the control group, the use of real ESPB with or without the addition of magnesium significantly decreased the Numeric Rating Scale score for pain during the first week of follow-up (P < 0.05); decreased the mean daily consumption of pregabalin and acetaminophen from the third to the twelfth week of follow-up (P < 0.05); and increased the level of patients' satisfaction (P = 0.03). The addition of magnesium sulphate showed an insignificant difference in comparison to the use of bupivacaine alone in ESPB (P ? 0.05).
The study was limited by being a singlecenter study, using a single-level injection, and using a single volume of local anesthetic mixture.
ESPB with or without adding magnesium sulphate is an effective pain management tool for cases of PHN. It leads to a significant decrease in pain score and analgesic requirements.
治疗疱疹后神经痛（PHN）的最佳方法仍存在争议。超声引导竖脊肌平面阻滞（ESPB）在 PHN 患者中的应用可能会降低疼痛严重程度和对镇痛药的需求。
本临床研究旨在测试 ESPB 联合和不联合硫酸镁对 PHN 患者疼痛控制和镇痛药消耗的疗效。
随机对照双盲试验。
单一大学中心。
共有 75 例 PHN 患者纳入本研究。患者随机分为 3 组，每组 25 例。A 组接受假 ESPB（2 mL 生理盐水），B 组接受 20 mL 布比卡因（0.25%）的 ESPB，C 组接受 20 mL 布比卡因（0.25%）和 100 mg 硫酸镁的 ESPB。所有患者均接受标准医疗护理。测量并记录疼痛评分、普瑞巴林和对乙酰氨基酚的消耗、并发症发生率和患者满意度。
与对照组相比，真正的 ESPB 联合或不联合硫酸镁的应用在随访的第一周显著降低了疼痛的数字评分量表评分（P < 0.05）；从第三周到第十二周，平均每日普瑞巴林和对乙酰氨基酚的消耗量均降低（P < 0.05）；并提高了患者满意度（P = 0.03）。与单独使用布比卡因相比，硫酸镁的添加在 ESPB 中没有显著差异（P？0.05）。
本研究的局限性在于为单中心研究，采用单水平注射，局部麻醉混合液使用单一容量。
ESPB 联合或不联合硫酸镁硫酸盐是 PHN 病例有效的疼痛管理工具。它可以显著降低疼痛评分和镇痛药的需求。
