Background: Acute herpes zoster causes severe neuropathic pain and may progress to postherpetic neuralgia (PHN). This study aims to evaluate ultrasound-guided thoracic paravertebral block with local anesthetic and steroid in reducing acute pain and PHN incidence.

Methods: This prospective randomized study included 100 patients diagnosed with acute thoracic herpes zoster (rash ≤14 days, NRS ≥4). Participants were allocated into two groups: a control group receiving standard medical treatment and an intervention group receiving standard treatment in addition to an ultrasound-guided thoracic paravertebral block with (0.25% bupivacaine + 40 mg methylprednisolone) at 48-72-hour intervals. Pain intensity was assessed at baseline and during follow-up. The incidence of postherpetic neuralgia was recorded. Secondary outcomes included analgesic consumption and patient satisfaction.

Eligibility Criteria Inclusion Criteria

Age 45-65 years

Diagnosed with acute thoracic herpes zoster

Rash duration ≤ 14 days

Moderate to severe pain, defined as NRS ≥ 4

Total sample size: 100 patients

Exclusion Criteria

Contraindications to thoracic paravertebral block, including:

Coagulopathy

Infection at the injection site

Allergy to local anesthetics or steroids

Immunosuppression or ongoing chemotherapy

Pre-existing chronic pain in the same affected region

Severe cognitive impairment or psychiatric illness preventing reliable pain assessment

Pregnancy or lactation

Plan Description

De-identified individual participant data (IPD) will not be shared outside the study team.

Access Criteria

Not applicable.