Evaluation of the role of Erector Spinae Plane Block versus conventional medical therapy in the management of Acute Thoracic Herpetic Neuralgia and the degree of patient satisfaction

Background: Acute herpetic neuralgia (AHN) markedly impacts patients' functional level and quality of life, resulting in elevated health service consumption. Modern interventional therapies for acute herpetic neuralgia encompass epidural injections, paravertebral blocks, intercostal nerve blocks (ICNB), and erector spinae plane blocks (ESPB). This study sought to assess the efficacy of ESPB and conventional medical treatment in the management of AHN and the prevention of post-herpetic neuralgia (PHN). Aim: To improve pain treatment for acute herpetic neuralgia and limit the likelihood of developing PHN. Methods: Thirty patients with acute herpetic neuralgia, aged 18 to 60, classified as ASA I and II, were recruited and randomly assigned to two groups: control and ESPB. Pain in the ESPB group was evaluated using VAS scores at 1 hour, 24 hours, 2 weeks, 4 weeks, and 12 weeks post-intervention, and total analgesic usage was documented. Results: The ESPB group exhibited the lowest values in VAS measurements at rest and during movement (p < 0.001). Significant differences were observed. Pain resolution time also varied considerably (p < 0.001), with an average of 12.93 ± 0.26 days for the medical group and 7.27 ± 5.06 days for the ESPB group. In addition, the medical group had a substantially higher gaptin administration (9.87 ± 1.41 weeks) than the ESPB group (5.07 ± 0.8 weeks) (p < 0.001). Conclusion: ESPB acts as an effective adjunct to conventional treatment for acute thoracic herpetic neuralgia.