Epidural steroid injection provides pain relief, improves sleep quality, and lowers analgesics in patients with postherpetic neuralgia (PHN). The use of adjuvant hypertonic saline (HS) with epidural block does not have any additional benefits in patients with PHN, a study published in “Pain Research and Management” described.

Hyun-Jung Kwon et al. compared the effectiveness of adding Hypertonic Saline and Normal Saline to epidural injections in patients with PHN at a medical centre in Seoul, Republic of Korea. Thirty-six patients with PHN even after 4 months of herpes zoster beginning were registered and allocated to two groups: Hypertonic saline (HS group, 17 patients) or Normal saline (NS group, 19 patients). After the use of epidural block with adjuvant HS or NS, the outcomes were examined at baseline and 1 and 3 months. Pain intensity on the numerical rating scale (NRS) was the primary outcome.

Medication quantification scale (MQS), global perceived effect of satisfaction (GPES) and insomnia severity index (ISI) were a part of secondary outcomes. The assessed pain intensity reduced in both groups after 1 and 3 months, but not significantly. The assessed ISI and MQS considerably reduced at 3 months (but not after 1 month) in each group, without group differences. No change was detected between the groups on the GPES at specified time points.

As this randomized trial did not show any beneficial effects of adjuvant HS use with epidural steroid injection in PHN patients, future research in this context is needed for a better understanding of the effectiveness of HS for neuropathic pain treatment like for PHN, as concluded by the study authors.