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This chapter presents a brief overview of frequently utilized invasive interventions for the treatment of neuropathic pain as well as the available evidence supporting its use. Interventional approaches discussed in the chapter include the use of intravenous infusions, sympathetic and peripheral nerve blocks, epidural blocks, botulinum toxin therapies, and implantable neuromodulation devices. The most common indication for sympathetic blockade is in the treatment of complex regional pain syndrome (CRPS). One of the initial applications of radiofrequency was in the treatment of trigeminal neuralgia. The most common medications delivered by implantable drug delivery systems include opioids, local anesthetics, adrenergic agonists, N-methyl-D-aspartate (NMDA) receptor agonists, and other agents. Systemic lidocaine delivery has been used for many years for chronic pain management. Future studies are required to better clarify safety, appropriate dosing, and applicability to various neuropathic pain conditions in larger study populations.
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