[Ultrasound-guided erector spinae plane block combined with pregabalin for post-herpetic neuralgia]

Objective: To analyze the clinical effect of ultrasound-guided erector spinae block combined with pregabalin on post-herpetic neuralgia (PHN) in the elderly. Methods: Sixty patients with post-herpetic neuralgia from January 2018 to January 2019 in the Department of Pain, First Affiliated Hospital of Bengbu Medical College were selected. The patients were divided into two groups according to the random number table (n=30): group C and ultrasound-guided erector spinae block (ESPB) group. Group C was treated with the oral drug pregabalin. ESPB group was treated with ultrasound-guided erector spinae block combined with oral drug pregabalin. The digital rating scale (NRS) score, sleep quality score (QS), total pregabalin dosage, and correlation during treatment were recorded before and after treatment at 1, 2, 3, 4, 6, and 8 weeks after treatment. Results: Four weeks after treatment, the scores of NRS and QS in ESPB group were 2.00(2.00-3.00) and 1.00(1.00-2.00) respectively, which were significantly lower than those in group C 3.00(3.00-4.00) and 2.00(2.00-3.00). The differences were statistically significant (Z=-2.318,-2.533, all P<0.05). The dosage of pregabalin in ESBP group was 1.73(1.65-1.99)g, less than that in group C 7.28(7.28-7.28)g, and the difference was statistically significant (Z=-4.916, P<0.05). The NRS score and QS score of ESPB group at the 8th week of follow-up were 2.50(2.00-4.00) and 1.00(0.00-2.00), respectively, which were significantly lower than those of group C 4.00(3.00-4.00) and 1.00(1.00-2.00). The difference was statistically significant (Z=-2.426,-2.691, all P<0.05). The significant effective rate of ESPB group was 70.0%, which was significantly better than that of group C (36.7%). The difference was statistically significant (χ(2)=6.694, P<0.05). Adverse reactions were mild in both groups. Conclusion: Ultrasound-guided erector spinae block can effectively alleviate the pain of elderly patients with PHN in the chest, significantly reduce the dosage of oral drugs, improve the sleep quality of patients, and have higher safety.