To investigate the effectiveness of ultra-Sound guided Erector spinae block (ESB) with Betamethasone as an adjuvant to standard medical protocol in the management of truncal chronic post herpetic neuralgia.
Patients age between 18 and 75.
Patients with American Society of Anesthesiologists (ASA) II and III status.
Patients diagnosed with truncal chronic post herpetic neuralgia( neuropathic pain persistent for more than 3 months from the onset of rash appearance )
Patients unable to comprehend the informed consent.
Patients on long term opioid regimens.
Patients with impairment in hepatic (Alanine aminotransferase (ALT) >50 U/L, and/or Aspartate aminotransferase (AST): >45 U/L) or renal functions( creatinine level ≥1.5 mg/dL)
Patients on anti-coagulation regimens.
Parallel
Medical management regimen
Other interventionPatients will receive the standard medical regimen alone.
Erector spinae plane (ESP) block
Other interventionPatients will receive erector spinae plane (ESP) block with betamethasone with standard medical regimen.
Pain degree
The degree of pain will be obtained and recorded on a numeric rating scale (NRS) with 0=no pain, and 10=Maximum pain intensity. Pain NRS score will be assessed at 2,4,6,8 weeks after the first clinic visit.
Incidence of side effects
Incidence of side effects for medications regimen (excessive sleepiness, nausea, vomiting allergic reaction, diarrhea, blurred vision, disorientation).
Incidence of side effects
Incidence of side effects for ESP block (local hematoma, limb numbness or weakness, dizziness, pneumothorax, hypotension, infection, allergic reaction).
Tramadol consumption in both groups.
Total consumption of tramadol in both groups will be recorded
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