The present study aims to evaluate the efficacy of ultrasound-guided erector spinae plane block with steroids to relieve pain in cases of post-herpetic neuralgia, patient satisfaction, and record any complications post-injection.

The current study will be conducted as a single-blinded prospective randomized controlled study to evaluate the efficacy of ultrasound-guided erector spinae plane block with steroids to relieve pain in cases of post-herpetic neuralgia.

All patients will be evaluated by:

• Full history taking: including age, sex, presence of co-morbid conditions as well as the presenting complaint.

• Clinical examination and routine lab investigations that include:

  • Complete blood count (CBC).
  • Fasting blood glucose (FBG).
  • Coagulation profile (bleeding time, prothrombin time, prothrombin activity, international normalized ratio).

Measurements:

Patients will be followed up at 24 hours, 1 week, and 6 weeks after injection.

The following measurements will be recorded:

1. Pain will be assessed pre- and post-injection using VAS score at 24 hours, 1 week, and 6 weeks post-injection.
2. Need for analgesic intake post-injection will be assessed at the follow-up periods.
3. Patient satisfaction using the SAPS score.
4. Complications post-injection as pain, irritation or infection will be assessed.

Inclusion Criteria:

• Patients with post-herpetic neuralgia not responding to medical treatment.

Exclusion Criteria:

- 1- Patient refusal 2- Age less than 20 years or older than 70 years. 3- Systemic Infection. 4-Patients with dementia or other diseases that could have impaired their memory or cognitive function.

5- Immunocompromised patients, severe osteoporosis, and uncontrolled diabetes mellitus.