Single paravertebral blockade seems safe in herpes zoster

(HealthDay)—For patients with acute thoracic herpes zoster (HZ), a single paravertebral blockade seems safe and effective, according to a study published in the March issue of Pain Practice.

Mohamed Y. Makharita, M.D., from Mansoura University in Egypt, and colleagues examined the efficacy of a single thoracic paravertebral injection in acute thoracic HZ pain, eruptive duration, and the incidence of postherpetic neuralgia (PHN). A total of 138 patients with acute thoracic herpetic eruption aged over 50 years were randomized to receive a paravertebral block using saline (placebo group) or bupivacaine plus dexamethasone (active group); all patients received pregabalin daily.

The researchers found that, compared with the placebo group, the active group had significantly shorter duration of pain (P = 0.013) and herpetic eruption (P < 0.001). At the third week, the active group had significantly lower pain severity, assessed with the visual analog score. The active group consumed significantly lower doses of pregabalin and acetaminophen. After three months, the incidence of PHN was comparable in both groups (P = 0.094). At six months, the active group had a significantly lower incidence of PHN (P = 0.048).

"Early single paravertebral blockade in the course of acute thoracic HZ seems to be a safe and effective adjuvant treatment modality," the authors write.