Ultrasound-guided paravertebral nerve block for zoster-associated pain: A meta-analysis / 中国组织工程研究

ABSTRACT

BACKGROUND: Current studies have shown that ultrasound-guided paravertebrospinai nerve block widely used has a significant effect in the clinical treatment of thoracolumbar zoster-associated pain. OBJECTIVE: To systematically evaluate the efficacy and safety of ultrasound-guided paravertebral nerve block in the treatment of thoracolumbar zoster-associated pain and to provide reference for clinical treatment. METHODS: We searched relevant literature in PubMed, The Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), WanFang Data, China Science and Technology Journal Database (VIP) and Chinese Biomedical Literature Database (CBM). The limit of searching time was from inception until January 1, 2019. Randomized controlled trials addressing ultrasound-guided paravertebral nerve block (experimental group) versus drug therapy (control group) for the treatment of acute zoster-associated pain or postherpetic neuralgia were collected according to the criteria for inclusion and exclusion. Literature quality was assessed according to Cochrane Handbook 5.1.0 bias risk assessment tool. The literature data were analyzed using Revman 5.3 software through a Meta-analysis. RESULTS AND CONCLUSION: A total of 11 randomized controlled trials involving 916 patients met the inclusion criteria. The results of Meta-analysis showed that compared with the control group, the ultrasound-guided paravertebral nerve block group had better analgesic effect and the optimal analgesic effect appeared within 1-4 weeks. A random effects model was then used [1st week Mean difference (MD)=-0.91, 95% confidence interval (Cl) (-1.22, -0.61), P < 0.000 01; 2nd week MD=-1.11, 95%C/(-1.52, -0.70), P < 0.000 01; 3rd week MD=-1.26, 95%C/(-1.79, -0.74), P < 0.000 01; 4th week MD=-0.90, 95%C/(-1.57, -0.24), P=0.007], At the same time, the quality of sleep and the effective rate of treatment were improved, and a fixed effects model was used [odds ratio=3.63, 95%C/(2.38, 5.53), P < 0.000 01]. The statistical results showed significant difference. There was no increase in post-treatment adverse reactions. Therefore, ultrasound-guided paravertebral nerve block is safe and effective for the treatment of zoster-associated pain in the thoracolumbar region.