Effectiveness of Ultrasonography-Guided Serratus Posterior Superior Intercostal Plane Block in Thoracic Postherpetic Neuralgia: A Retrospective Cohort Study

Phase

N/A

Condition

Pain (Pediatric)

Pain

Treatment

N/A

Clinical Study ID

NCT07067892

postherpetic neuralgia, block

Ages > 18
All Genders

Study Summary

Postherpetic neuralgia (PHN) is a chronic pain syndrome that can be resistant to treatment, leading to physical and social disability, psychological disturbances, and potentially persisting for years . The varicella-zoster virus remains latent in the sensory neurons of individuals who have previously contracted varicella (chickenpox). Reactivation of the latent virus results in herpes zoster (HZ). In most patients, HZ initially presents with dermatomal pain, and within a few days, characteristic dermatomal vesicular eruptions typically develop. These skin lesions usually heal within 2-4 weeks; however, pain may persist even after the resolution of the rash .

The pathogenesis of PHN involves increased sensitization of central neurons, decreased function of inhibitory neuronal pathways, inflammation and nerve injury within the peripheral nervous system, and abnormal signal transmission following such damage. PHN represents the most common complication of HZ. It occurs in approximately 9-19% of all patients with HZ. The incidence of PHN increases with advancing age: it affects approximately 2% of individuals younger than 50 years, about 20% of those older than 50 years, and nearly 35% of those older than 80 years . Various treatment modalities, including pharmacologic agents and interventional procedures, are available for the management of PHN-related pain.

Eligibility Criteria

Inclusion

Inclusion Criteria:

Patients over 18 years of age

who underwent a single-session ultrasound (US)-guided serratus posterior superiorintercostal plane block (SPSIPB) in the thoracic region (T1-T10 dermatomes) for PHNbetween June 2023 and February 2025 were evaluated. -SPSIPB was performed inpatients whose complaints persisted despite existing medical treatments.

Exclusion

Exclusion Criteria:Patients were excluded if they had cervical disc herniation -a history of trauma or surgery involving the neck, shoulder, or back; -malignancy- kyphoscoliosis; a history of inflammatory diseases (e.g., rheumatoid arthritis, ankylosing spondylitis)

congenital anomalies of the spine; neck pain accompanied by neurological deficits
pregnancy
mental or psychotic disorders
hematologic diseases causing bleeding or coagulation disorders
use of antiplatelet or anticoagulant drugs or other medications predisposing tobleeding
severe systemic infections such as sepsis
local infection at the planned intervention site
known allergy to any of the drugs to be used; or a history of invasive proceduresfor PHN in the thoracic region within the past three months.

Study Design

June 01, 2025

August 15, 2025

Study Description

After obtaining approval from the relevant ethics committee (University of Health Sciences, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, KAEK/2025.05.139), patients over 18 years of age who underwent a single-session ultrasound (US)-guided sub-pectoral spinal intercostal plane block (SPSIPB) in the thoracic region (T1-T10 dermatomes) due to PHN between June 2023 and February 2025 were retrospectively evaluated. SPSIPB was performed in patients whose complaints persisted despite existing medical treatments. The study was conducted in accordance with the Declaration of Helsinki. Written informed consent was obtained from all patients enrolled in the study, which was carried out at the pain clinic of a tertiary care hospital. This retrospective, single-center cohort study was designed in compliance with the STROBE (The Strengthening the Reporting of Observational Studies in Epidemiology) guidelines (8).

A total of 34 patients who met the inclusion criteria were included in the study .

Patients were excluded if they had cervical disc herniation; a history of trauma or surgery involving the neck, shoulder, or back; malignancy; kyphoscoliosis; a history of inflammatory diseases (e.g., rheumatoid arthritis, ankylosing spondylitis); congenital spinal anomalies; neck pain accompanied by neurological deficits; pregnancy; mental or psychotic disorders; hematologic diseases causing bleeding or coagulation disorders; use of antiplatelet or anticoagulant drugs or medications predisposing to bleeding; severe systemic infections such as sepsis; local infections at the planned intervention site; known allergies to any of the drugs to be used; or a history of invasive procedures for PHN in the thoracic region within the past 3 months.

Connect with a study center

İKanuni Sultan Süleyman Training and Research Hospital
Küçükçekmece, İ̇stanbul (507) 277-4773
Turkey
Active - Recruiting

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