【Pain topic】The effect of erector spinal plane block with and without magnesium on the relief of postherpetic neuralgia

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The Effect of Erector Spinae Plane Block With and Without Addition of Magnesium on Relief of Pain from Post-herpetic Neuralgia.

Effects of erector spinal plane block with and without magnesium in the relief of postherpetic neuralgia

1

Background

Background: The best tool for management of postherpetic neuralgia (PHN) is a matter of debate.
The use of ultrasound-guided erector spinae plane block (ESPB) in patients with PHN may decrease pain severity and the need for analgesics.

Background: The optimal treatment for postherpetic neuralgia (PHN) remains controversial
.
The use of ultrasound-guided erector spinal plane block (ESPB) in patients with PHN may reduce the severity of pain and the need
for analgesics.

2

Objectives

Objectives: The objective of this clinical study was to test the efficacy of ESPB with and without the addition of magnesium sulphate on pain control and analgesic consumption in patients with PHN.

Objective: The purpose of this clinical study was to test the efficacy
of ESPB with and without magnesium sulfate on pain control and analgesic depletion in patients with PHN.

3

Study Design

Setting

Study Design: Randomized controlled double-blinded trial.

Setting: A single university center.

Study design: randomized controlled double-blind trial
.

Environment: A university center
.

2

Methods

Methods: A total of 75 patients with PHN were included in the study.
Patients were randomly divided into 3 equal groups.
Group A received sham ESPB (2 mL normal saline), Group B received ESPB with 20 mL of bupivacaine (0.
25%), and Group C received ESPB with 20 mL of bupivacaine (0.
25%) and 100 mg magnesium sulphate.
All patients received standard medical care.
The pain score, the consumption of pregabalin and acetaminophen, the incidence of complications, and the patient’ s satisfaction were measured and recorded.

Methods: A total of 75 patients with PHN were enrolled in the study
.
Patients were randomly divided into 3 equal groups
.
Group A received a sham ESPB (2 mL of normal saline), group B received ESPB containing 20 mL of bupivacaine (0.
25%), and Group C received ESPB
containing 20 mL of bupivacaine (0.
25%) and 100 mg magnesium sulfate.
All patients received standard medical care
.
Pain scores, pregabalin and acetaminophen consumption, complication rates, and patient satisfaction
were measured and recorded.

3

Results

Results: In comparison to the control group, the use of real ESPB with or without the addition of magnesium significantly decreased the Numeric Rating Scale score for pain during the first week of follow-up (P < 0.
05); decreased the mean daily consumption of pregabalin and acetaminophen from the third to the twelfth week of follow-up (P < 0.
05); and increased the level of patients’ satisfaction (P = 0.
03).
The addition of magnesium sulphate showed an insignificant difference in comparison to the use of bupivacaine alone in ESPB (P ˃ 0.
05).

Results: True ESPB with or without magnesium significantly reduced the numerical rating scale score for pain compared with the control group (P < 0.
05); From weeks 3 to 12 of follow-up, the mean daily consumption of pregabalin and acetaminophen decreased (P < 0.
05); Patient satisfaction was improved (P = 0.
03).

The addition of magnesium sulfate to ESPB showed a non-significant difference compared to bupivacaine alone (P ˃ 0.
05).

2

Limitations

Limitations: The study was limited by being a singlecenter study, using a single-level injection, and using a single volume of local anesthetic mixture.

Limitations: The study was a single-center study that used a single level of injection and used a single volume of local anesthetic mixture
.

3

Conclusion

Conclusion: ESPB with or without adding magnesium sulphate is an effective pain management tool for cases of PHN.
It leads to a significant decrease in pain score and analgesic requirements.

Conclusion: ESPB with or without magnesium sulfate is an effective PHN pain treatment tool
.
It leads to a significant reduction in
pain scores and the need for painkillers.

Statistical results show:

1.
 Demographic data and incidence of complications of the studied groups.

2.
The Numeric Rating Scale score in the studied groups.

3.
The mean daily consumption of pregabalin and acetaminophen.

The Effect of Erector Spinae Plane Block With and Without Addition of Magnesium on Relief of Pain from Post-herpetic Neuralgia.
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