Chronic opioid therapy as alternative treatment for post‐herpetic neuralgia

Neurosurgical procedures such as the dorsal root entry zone operation, ganglionectomy, and spinal‐cord stimulation have been offered to patients with intractable post‐herpetic neuralgia (PHN). Poor efficacy or high morbidity have limited the overall usefulness of these procedures. We recently conducted a preliminary open‐label study with long‐acting oral opioids. The mean pretreatment pain score, on a scale of 0 to 10 (0 = no pain) was 9.0 ± 0.3 (mean ± SEM, N = 20). At two months of treatment the average pain score was 4.0 ± 0.4 (p < 0.001, paired t test), and at six months the average pain score was 3.8 ± 0.2 (p < 0.001, N = 16). These observations warrant a controlled opioid trial for patients affected by PHN.