{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:21:28Z","timestamp":1787772088052,"version":"build-2784847793"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,7]]},"abstract":"Abstract<\/jats:title>\n \n Background and Aims:<\/jats:title>\n The treatment for postherpetic neuralgia (PHN) continues to be challenging in clinical pain management. Paravertebral block (PVB) and erector-spinae block (ESPB) are two novel techniques for treating this distressing condition. We aimed to assess the effectiveness of PVB and ESPB in preventing the progression to PHN in patients with acute herpes zoster (AHZ).<\/jats:p>\n <\/jats:sec>\n \n Material and Methods:<\/jats:title>\n \n Sixty patients in pain due to AHZ were selected for a prospective randomized control study after approval from Institutional Ethical Committee. Written informed consent was taken. Patients were randomized and allotted into Control-group: standard treatment (oral antivirals, analgesics, neuropathic medicines); PVB-Group: standard treatment with PVB and ESPB- Group: standard treatment with ESPB. Under ultrasound guidance, both blocks were administered with 20 ml of 0.25% bupivacaine + dexamethasone 8 mg. Efficacy was evaluated on the 15\n th<\/jats:sup>\n , 30\n th<\/jats:sup>\n , and 60\n th<\/jats:sup>\n day post treatment. The primary endpoint was the proportion of patients with adequate relief from pain and allodynia post study.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The incidence of PHN post study was 45% in the ESPB group and 40% in the PVB group and 80% in the control group (\n p<\/jats:italic>\n = 0.022). The proportion of patients with pain relief was higher among the PVB group compared to the ESPB group but not statistically significant (\n p<\/jats:italic>\n 0.749). On day 60, the mean pain score was 2.45 (\u00b13.05) and 2.15 (\u00b12.7) in ESPB and PVB groups, respectively, and 4.3 (\u00b12.27) in the control group (\n p<\/jats:italic>\n 0.003).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n PVB and ESPB are effective approaches in treating patients suffering from pain due to acute zoster and help in preventing its progression to PHN.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/joacp.joacp_82_23","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T18:21:47Z","timestamp":1711563707000},"page":"510-515","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":12,"title":["A Randomized clinical trial comparing the efficacy of ultrasound-guided erector spinae block and paravertebral block in preventing postherpetic neuralgia in patients with zoster-associated pain"],"prefix":"10.4103","volume":"40","author":[{"given":"Akkamahadevi","family":"Patil","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Dr. Moopens Medical College, Meppadi, Wayanad, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Vyshnavi","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Venereology and Leprosy, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanigai","family":"Raja","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Venereology and Leprosy, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veeranna","family":"Shastry","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprosy, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivas H.","family":"Thammaiah","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Venereology and Leprosy, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KN","family":"Archana","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Venereology and Leprosy, JSS Academy of Higher Education and Research, Mysuru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,3,28]]},"reference":[{"key":"R1-20240830","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1093\/bja\/ael007","article-title":"Repetitive paravertebral nerve block using a catheter technique for pain relief in post-herpetic neuralgia","volume":"96","author":"Naja","year":"2006","journal-title":"Br J 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block combined with medication in the treatment of zoster-related pain with different courses","volume":"26","author":"Liu","year":"2021","journal-title":"Neurosci Riyadh Saudi Arab"},{"key":"R7-20240830","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1097\/AAP.0000000000000451","article-title":"The erector spinae plane block:A novel analgesic technique in thoracic neuropathic pain","volume":"41","author":"Forero","year":"2016","journal-title":"Reg Anesth Pain Med"},{"key":"R8-20240830","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.jclinane.2018.08.016","article-title":"Ultrasound guided bi-level erector spinae plane block for pain management in Herpes Zoster","volume":"52","author":"Balaban","year":"2019","journal-title":"J Clin Anesth"},{"key":"R9-20240830","doi-asserted-by":"crossref","first-page":"375.e1","DOI":"10.1016\/j.ajem.2018.10.028","article-title":"High-thoracic ultrasound-guided erector spinae plane block for acute herpes zoster pain management in emergency department","volume":"37","author":"Tekin","year":"2019","journal-title":"Am J Emerg Med"},{"key":"R10-20240830","first-page":"E977","article-title":"Ultrasound-guided erector spinae block versus ultrasound-guided thoracic paravertebral block for pain relief in patients with acute thoracic herpes zoster:A randomized controlled trial","volume":"25","author":"Abdelwahab","year":"2022","journal-title":"Pain Physician"},{"key":"R11-20240830","doi-asserted-by":"crossref","first-page":"1651","DOI":"10.1213\/ANE.0b013e3181b79075","article-title":"The effectiveness of repetitive paravertebral injections with local anesthetics and steroids for the prevention of postherpetic neuralgia in patients with acute herpes zoster","volume":"109","author":"Ji","year":"2009","journal-title":"Anesth Analg"},{"key":"R13-20240830","first-page":"229","article-title":"Single paravertebral injection for acute thoracic herpes zoster:A randomized controlled trial","volume":"15","author":"Makharita","year":"2015","journal-title":"Pain Pract Off J World Inst Pain"},{"key":"R14-20240830","doi-asserted-by":"crossref","first-page":"R6","DOI":"10.1007\/BF03018333","article-title":"Paravertebral anesthesia and analgesia","volume":"51","author":"Richardson","year":"2004","journal-title":"Can J Anesth"},{"key":"R15-20240830","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1097\/00000539-200006000-00026","article-title":"Thoracic paravertebral block for breast surgery","volume":"90","author":"Klein","year":"2000","journal-title":"Anesth Analg"},{"key":"R16-20240830","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1213\/00000539-199808000-00025","article-title":"The effect of thoracic paravertebral blockade on intercostal somatosensory evoked potentials","volume":"87","author":"Richardson","year":"1998","journal-title":"Anesth Analg"},{"key":"R17-20240830","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/S0140-6736(06)68032-X","article-title":"The PINE study of epidural steroids and local anaesthetics to prevent postherpetic neuralgia:A randomised controlled trial","volume":"367","author":"van","year":"2006","journal-title":"Lancet Lond Engl"}],"container-title":["Journal of Anaesthesiology Clinical Pharmacology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/joacp.joacp_82_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:29:39Z","timestamp":1787768979000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/joacp.joacp_82_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,28]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/joacp.joacp_82_23","relation":{},"ISSN":["0970-9185","2231-2730"],"issn-type":[{"value":"0970-9185","type":"print"},{"value":"2231-2730","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,28]]},"assertion":[{"value":"2023-02-28","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-17","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}