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

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.