Effect of dexmedetomidine combined with ropivacaine in ultrasound-guided paravertebral nerve block for acute herpes zoster neuralgia patients.

PURPOSE: Early and effective treatment of acute herpes zoster (AHZ) can relief the pain and prevent the occurrence of postherpetic neuralgia (PHN) in patients. The aim of this study is to investigate the efficacy of dexmedetomidine combined with ropivacaine in ultrasound-guided paravertebral nerve block for patients with AHZ neuralgia. MATERIALS AND METHODS: Seventy-four patients suffering from acute thoracic herpes zoster neuralgia were divided into two equal groups in a prospective, randomized, double-blind controlled manner. All patients received paravertebral nerve block under ultrasound guidance with different drugs: Group I: 0.2% ropivacaine with 1 μg/kg dexmedetomidine; Group II: 0.2% ropivacaine, all drugs were diluted with normal saline to a total of 20 ml. The patients' Visual Analog Scale (VAS) scores were used for assessing pain level while the quality of sleep (QS) scores were used for assessing sleep levels 1, 4, 8, and 12 weeks after the treatment, as well as the pregabalin consumption. Time to pain resolution and skin eruption, total times of block, complications within 24 h after block, and the incidence of persistent PHN at 3 and 6 months were analyzed. RESULTS: There were no significant differences in the VAS scores between the two groups at various time points (P > 0.05). At the time point 1, 4, and 8 weeks after treatment, the QS scores in Group I were significantly lower than that in Group II (P < 0.05). The pregabalin consumption and the incidence of PHN between the two groups were not significantly different (P > 0.05). The total times of block in Group I were significantly less than Group II. CONCLUSION: Both interventions provided similar efficacy in minimizing the pain intensity and reducing the incidence of PHN in AHZ patients. Compared with ropivacaine only, the addition of dexmedetomidine significantly improved patients' sleep quality and reduced the times of block.