Abstract
A 83-year-old man had suffered severe from postherpetic neuralgia for 8 years. He received cervical dorsal rhizotomy in C2, C3, and C4 for unbearable allodynia. Although deep hypesthesia on all the skin of the right C2-C4 dermatomes was noted after the dorsal rhizotomy, cramping pain and brief recurrent shooting pain on the right cervical area were persistent Various therapies including C4 root block, topical capsaicin, dextromethorphan, ketamine, lidocaine and mexiletine could not attenuate his pain. We reexamined several drugs for his pain. Intravenous morphine at 5mg reduced his pain effectively. We decided to prescribe slow-release morphine at 60mg/day and amitriptyline at 10mg/day, orally. This painful condition was relieved with morphine in his last days.
