Erector Spinae Plane Block Versus Transcutaneous Radiofrequency in Postherpetic Neuralgia

Diskapi Teaching and Research Hospital50 enrolled

Overview

This observational study aims to compare the effectiveness of ultrasound-guided erector spinae plane (ESP) block and transcutaneous radiofrequency (RF) treatment in patients with postherpetic neuralgia. Pain intensity and neuropathic pain characteristics will be evaluated using the Visual Analog Scale (VAS) and the Self-Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) score.

Postherpetic neuralgia is a challenging neuropathic pain condition that significantly affects quality of life. In routine clinical practice, patients are treated with either ultrasound-guided erector spinae plane block or transcutaneous radiofrequency therapy based on clinician preference and experience. This observational study includes patients who have already completed one of these treatments as part of standard care in the Algology Clinic. No randomization or modification of treatment plans was performed for research purposes. Patients will be divided into two cohorts according to the treatment they received. Treatment outcomes will be retrospectively evaluated and compared using VAS and S-LANSS scores before treatment, immediately after treatment, and at 1-month follow-up.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Postherpetic Neuralgia Neuropathic Pain Herpes Zoster

Interventions

1. Ultrasound-guided erector spinae plane block performed under sterile conditions as part of routine clinical care. After skin antisepsis, a 22-G spinal needle was advanced to the erector spinae plane at the level corresponding to the affected dermatome, and a total volume of 10 mL consisting of dexamethasone, bupivacaine, and normal saline was injected. Patients were observed post-procedure according to standard clinical practice. 2. Transcutaneous radiofrequency treatment applied adjacent to the affected dermatome as part of routine clinical care. Adhesive surface electrodes were placed over the painful area, and pulsed electrical stimulation was delivered by the device for 10 minutes per session. The procedure was performed once weekly for two sessions, without any modification for research purposes.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: Diagnosis of postherpetic neuralgia involving cervical, thoracic, or lumbar regions Age between 18 and 80 years Persistent pain despite conservative treatment Baseline VAS score \> 5 Exclusion Criteria: Ophthalmic or extremity postherpetic neuralgia Allergy to local anesthetics Pregnancy Coagulopathy or use of antiplatelet therapy Cognitive impairment preventing informed consent

Outcomes

Primary Outcomes

VAS

Pain intensity assessed by Visual Analog Scale (VAS): is a simple tool used in clinical trials to measure pain intensity. Patients rate their pain on a scale, typically from 0 (no pain) to 10 (worst imaginable pain). It provides a quick, quantitative assessment of subjective pain and is commonly used to evaluate treatment effectiveness before and after intervention.

Time frame: Baseline, post-procedure 1 month

Secondary Outcomes

S-LANSS

Neuropathic pain characteristics were assessed using the Self-report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) questionnaire. The S-LANSS is a validated self-administered screening tool consisting of seven items evaluating pain quality and sensory abnormalities, including burning sensation, electric shock-like pain, dysesthesia, and altered skin sensitivity. Total scores range from 0 to 24, with scores ≥12 indicating a probable neuropathic pain component. The questionnaire has demonstrated good sensitivity and specificity for identifying neuropathic pain in both clinical and research settings.