An interventional study of Medical management regimen and Erector spinae plane (ESP) block in Postherpetic Neuralgia, Chronic Pain and Ultrasound Guidance, sponsored by Cairo University. Recruiting at 1 site in Egypt. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2025-06-05.
Sponsored by Cairo University · Not applicable, Interventional, and Treatment
To investigate the effectiveness of ultra-Sound guided Erector spinae block (ESB) with Betamethasone as an adjuvant to standard medical protocol in the management of truncal chronic post herpetic neuralgia.
Postherpetic neuralgia (PHN) is a syndrome described as zoster-associated pain persisting for more than 3 months after resolution of an initial herpes zoster (HZ) rash ("shingles").[This condition is considered to be the most prevalent and challenging complication associated with HZ infection. According to reports, around 75% of senior patients who contract HZ are likely to experience it. The incidence of it was observed to be 38.1%, 27.0%, and 19.0% at 1 month, 3 months, and 6 months, respectively, following the onset of zoster. Half of the patients who are more than 50 years have the risk of developing PHN. It is noteworthy that the incidence of PHN seems to be on the rise.
Erector spinae plane (ESP) block is one of the newer interfascial techniques where the drug is injected below the erector spinae muscle to spread towards the costotransverse foramina and origin of dorsal and ventral rami where it is supposed to work at the origin of spinal nerves, based on cadaveric and contrast studies. Cadaveric studies have also showed that a block at T5 level is sufficient to have unilateral multi-dermatomal sensory block ranging from T1 to L3. Thus, this block serves the purpose of a paravertebral block without the risk of pleural injury.
Betamethasone is a long-acting corticosteroid with immunosuppressive and anti-inflammatory properties. It can be used topically to manage inflammatory skin conditions such as eczema, and parenterally to manage several disease states including autoimmune disorders. Betamethasone has potent glucocorticoid activity and negligible mineralocorticoid activity. The beneficial effects of injecting steroids could be because of sympathetic blockage, thereby inhibiting vasoconstriction and due to anaesthetization of the dorsal root ganglion and posterior spinal nerve.
1,287 studies on the registry are indexed under Neuralgia; 256 are open to participants now.
This study's planned enrollment of 40 is below the median of 52 across 973 interventional studies indexed under Neuralgia.
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Exclusion Criteria:
Patients will receive the standard medical regimen alone.
Other: Medical management regimen
Patients will receive erector spinae plane (ESP) block with betamethasone with standard medical regimen.
Other: Erector spinae plane (ESP) block
Patients will receive the standard medical regimen alone.
Also known as: Paracetamol +-Gabapentin + Amitriptyline
Patients will receive erector spinae plane (ESP) block with betamethasone with standard medical regimen.
Pain degree
The degree of pain will be obtained and recorded on a numeric rating scale (NRS) with 0=no pain, and 10=Maximum pain intensity. Pain NRS score will be assessed at 2,4,6,8 weeks after the first clinic visit.
Time frame: 8 weeks after the first clinic visit.
Incidence of side effects
Incidence of side effects for medications regimen (excessive sleepiness, nausea, vomiting allergic reaction, diarrhea, blurred vision, disorientation).
Time frame: 8 weeks after the first clinic visit.
Incidence of side effects
Incidence of side effects for ESP block (local hematoma, limb numbness or weakness, dizziness, pneumothorax, hypotension, infection, allergic reaction).
Time frame: 8 weeks after the first clinic visit.
Tramadol consumption in both groups.
Total consumption of tramadol in both groups will be recorded
Time frame: 8 weeks after the first clinic visit.
Plan to share: Yes — The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
Supporting information: Study protocol
No publications or documents are linked to this record.
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Cairo University