I have been suffereing from RSD/CRPS for 11 years, following a trimaleolar fracture of my right ankle. I have tried just about every treatment available except for implated morphine pump and spinal stimulator. For the last 3 years I've been hospitalized for intravenous infusion of a combination of medication including ketamine, kepra, depakote, lidocaine, pamidrinate,fentanyl and magnesium. The treatment is continuous IV administration over a period of 4 days. This last month I was admitted for the above treatment with the addition of bipuvacaine and dilaudid which wa admimistered via epidural infusion simultaneously. This does not resolve the pain completely but does make it easier to bear. I must still maintain my oral medications which include cymbalta, wellbutrin, lamictal, duragesic patch 100 mcg and fentora 400 mcg as rescue for breakthrough pain. I generally need to take a fentora every 4-6 hours which works out to approx 4.5/day. I have also been prescribed oral ketamine prn, while this helps a great deal with burning I find it very different to tolerate due to the disorientation, almost to the point of being hallucinogenic, as well as nausea and headache. I take it when I am desperate and the burning is unrelieved by other means such as warm bath, lidocaine 10% compound cream. Additionally I use a compound cream composed of neurontin, flexeril and ketoprofen. This helps with the aching and stabbing. I also use 2 catapres patches placed at the site of the initial injury. This is very effective in controlling the vascular changes that result in color and temperature changes and somewhat with the swelling. Every 8 weeks or so I undergo IV infusion of lidocaine when the burning is intractable so I can keep a lid on it and avoid additonal hospitalizations. I would very much like to reduce the medication particularly the opiates but I've been totally unsuccessful. Before resorting to the aforementioned drug combinations I have tried chinese herb patches and accupuncture and biofeedback. I occasionally use a TENS unit mainly as a distraction. I am out of ideas. Do you know of anything that might help me or at least allow me to cut back on the narcotics?