According to the outcomes of a meta-analysis, combining methylprednisolone, local anesthetic, and standard intervention led to a reduction in visual analog scale (VAS) scores and incidence of long-term postherpetic neuralgia (PHN). Yuan Zhang et al. aimed to determine the effectiveness of local anesthetics combined with methylprednisolone on the intensity or occurrence of PHN.

Electronic databases such as China national knowledge infrastructure (CNKI), Cochrane Library, Web of Science, and PubMed were searched for relevant studies. The VAS scores and occurrence of PHN were the endpoints ascertained. A total of 5 randomized controlled trials with long-term duration and 980 volunteers were included.

A substantial reduction in the occurrence of PHN in 1 month (risk ratio, RR = 0.38), 3 months (RR = 0.40), and 6 months (RR = 0.37) after the outbreak of zoster was observed in people treated with the combination of standard intervention, local anesthetic, and methylprednisolone when compared to people treated with standard intervention (antivirals) alone.

In long-term PHN, there was a remarkable difference in VAS scores between both the arms (3 months: weighted mean difference= −1.57, 6 months: weighted mean difference= −0.72). Hence, methylprednisolone combined with local anesthetics and standard intervention appears to be beneficial for long-term PHN management. Additional analysis is required for determining the safety of this treatment, concluded the study authors.