Peripheral Nerve Blocks in the Management of Postherpetic Neuralgia: An Effective Interventional Technique for Improving Patients' Quality of Life

Introduction: Complications such as postherpetic neuralgia (PHN) are the most common in herpes zoster infection. The pain is often severe and can lead to impact the quality of life whereas the treatment of this kind of pain is challenging. We performed ultrasound guided nerve block for pain relief. Patients and methods: During the period from March 2023 to May 2024, we conducted a single-center, prospective and descriptive study covering all patients who had post-herpetic neuralgia (PHN)with a DN 4 score ≥ 5/10. The nerve blocks were performed under ultrasound regarding the metamere involved. The analgesic solution was ropivacaine 0,2% and dexamethasone 4mg. Results: The average age of our patients was 64.38 years and the sex ratio was 1.16. The majority had a score of more than 7/10, or 46% of the workforce. In 38% of cases the EVA was 7/10. The pain was accompanied by sensory disturbances such as cutaneous hyperesthesia in 62% of cases. Regarding the impact, a deterioration in general condition WHO stage 2 was noted in 61.6% of cases. In 23% of cases, pregabalin 75 mg was added to the paracetamol and tramadol combination. Haloperidol 5mg and amitriptyline 125mg were associated with these treatments in 1 case each, 7% of the total. Ultrasound guided paravertebral nerve block was mostly performed in 54% of cases. After 3 months of monitoring, 12 patients noticed their VAS score drop to 1/10. Only one needed a perineural catheter placement for pain relief. Conclusion: Peripheral nerve blocks is a good option in severe PHN where systemic analgesic failed.