Efficacy of Ultrasound‐Guided Intercostal Nerve Block With Liposomal Bupivacaine for Treating Postherpetic Neuralgia in Adult Patients

ABSTRACT

The study aimed to investigate the efficacy of ultrasound‐guided intercostal nerve block (ICNB) with liposomal bupivacaine (LB) comparing ropivacaine‐dexamethasone (RD) for treating postherpetic neuralgia (PHN) in adult patients. A total of 108 patients were randomized 1:1 to receive ICNB with LB or ICNB with RD. The Visual Analogue Scale scores in the ICNB‐LB were significantly lower than those in the ICNB‐RD at 1 and 2 weeks posttreatment ( p  < 0.001). According to the EuroQol Health‐Related Quality of Life 5‐Dimension, 3‐Level questionnaire (EQ‐5D‐3L), lower proportions of patients reporting problems at 2 weeks posttreatment were observed in the ICNB‐LB regarding the domains of pain/discomfort ( p  = 0.031), usual activities ( p  = 0.027), and symptom of anxiety/depression ( p  = 0.038), versus the ICNB‐RD. The ICNB‐LB had less consumption of pregabalin than the ICNB‐RD at 1 week ( p  = 0.006) and 2 weeks ( p  = 0.013) posttreatment. The rate of pregabalin discontinuation was higher and the proportion of patients who required rescue analgesics was lower in ICNB‐LB versus ICNB‐RD up to Week 2 posttreatment. These results demonstrate LB provides an analgesic superiority through 2 weeks without causing new safety concerns comparing with RD in ultrasound‐guided ICNB for treating adult patients with PHN.