BMJ Open. 2026 Aug 26;16(8):e118374. doi: 10.1136/bmjopen-2026-118374.
ABSTRACT
Postherpetic neuralgia (PHN) is the most common chronic complication of herpes zoster, characterised by persistent pain after the rash subsides with a particularly high incidence among the elderly population. Its pathological mechanism involves peripheral and central sensitisation, often leading to severe pain, sleep disturbances, emotional issues and a decline in quality of life, posing a significant burden on healthcare and society. Current clinical treatments primarily rely on pharmacological and interventional therapies yet their efficacy remains suboptimal. Stellate ganglion block (SGB), as an interventional technique targeting the sympathetic nervous system, is believed to alleviate PHN by modulating neurovascular function, inhibiting inflammatory responses and blocking pain transmission pathways. However, evidence-based data on its efficacy and safety remain insufficient and existing study results are inconsistent. Therefore, this study aims to comprehensively evaluate the effectiveness and safety of SGB in treating PHN through a systematic review and meta-analysis.
METHODS: This systematic review and meta-analysis will be conducted in strict accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic search will be performed for relevant randomised controlled trials published from the inception of each database until 31 December 2025, in PubMed, Embase, the Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Database and VIP Database. Two researchers will independently complete the literature screening, data extraction and cross-verification. The methodological quality of the included studies will be assessed using the Cochrane Risk of Bias tool. Statistical analysis will be performed using RevMan V.5.4 software: continuous variables will be analysed by calculating the mean difference and 95% CI, and dichotomous variables will be analysed by calculating the OR and 95% CI. Based on the results of heterogeneity testing (I² statistic), either a fixed-effects model or a random-effects model will be employed for data synthesis. Subgroup analyses and sensitivity analyses will be conducted to explore sources of heterogeneity, and a grading system will be used to assess the quality of the evidence.
ETHICS AND DISSEMINATION: Ethical approval is not required for this study, as it does not involve the collection of primary data from individual patients. Findings will be disseminated through peer-reviewed publication and conference presentations.
PROSPERO REGISTRATION NUMBER: CRD420251128909.
PMID:42648776 | DOI:10.1136/bmjopen-2026-118374
