Postherpetic neuralgia

I’ve had many patients in the past that are difficult to treat (read refractory). I have an 85yo patient with PHN following T12 and L1 dermatomes on the right. -tried: opiates in the past; does not want narcs, didn’t tolerate TCAs -currently on: Gabapentin (dose limited by renal insufficiency), on Cymbalta 60mg daily and Lidoderm. I did a T12-L1 interlam a few weeks ago. First time his pain has been below an 8 in the last 3 years since onset. Only lasted 3 days (80mg Depo and 3ml... Postherpetic neuralgia
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