About this trial
The primary objective of this clinical trial is to evaluate the efficacy of liposomal bupivacaine and ropivacaine in the treatment of pain associated with herpes zoster (shingles). This trial will also assess the safety profiles of both liposomal bupivacaine and ropivacaine.
The study aims to address the following key questions:
Does nerve blockade with liposomal bupivacaine or ropivacaine reduce the required dosage of gabapentin in participants? What medical issues, if any, arise in participants undergoing paravertebral block, intercostal nerve block, RISS (Radiofrequency Intervention for Spinal Segment); or pulsed radiofrequency (PRF)? Can nerve blocks, specifically paravertebral block, intercostal nerve block, RISS; and PRF, effectively treat severe postherpetic neuralgia (PHN)? The study will compare these interventions.
Study Procedures:
Participants will:Receive ultrasound-guided nerve blocks or pulsed radiofrequency every 48 hours, for a total of 3 treatments.
Undergo assessments, either in-person or via telephone, at the following time points: before therapy (baseline), on the day of treatment (Day 1), Day 7, Day 30, and Day 90 post-treatment.
Have their symptoms recorded, along with their scores on the Numerical Rating Scale (NRS) and the Zoster Brief Pain Inventory (ZBPI).
Eligibility criteria
Qualifiers
Presence of typical clinical manifestations of herpes zoster (shingles), including vesicular and painful rash.
Diagnosis of postherpetic neuralgia (PHN) lasting for more than one month, unresponsive to conventional treatment.
Visual Analog Scale (VAS) score ≥ 4.
Involvement of thoracic nerve roots.
Disqualifiers
Refusal to provide written informed consent.
Inability to cooperate with study assessments.
History of systemic autoimmune disease, organ transplantation, or cancer.
Prior receipt of other invasive pain treatments, such as spinal cord stimulation.
Trial design
Treatments tested in this trial
- Ultrasound-Guided Pulsed Radiofrequency (PRF)
- Intercostal nerve block (2% ropivacaine or 133 mg of liposomal bupivacaine)
- Paravertebral (PVB) Block (2% ropivacaine or 133 mg of liposomal bupivacaine)
- Rhomboid Intercostal and Subserratus Plane (RISS) Block (2% ropivacaine or 133 mg of liposomal bupivacaine)
- Drug (famciclovir and gabapentin)
Treatment groups
Sponsors and collaborators
Xiaguang Duan
Lead sponsor
Inner Mongolia Baogang Hospital
Sponsor institution