Cooling the burn: EMLA alone vs. paravertebral block plus EMLA for improving tolerability of 8% capsaicin patch application in thoracic postherpetic neuralgia—a retrospective cohort study

TPVB combined with EMLA yielded profound improvements in procedural tolerability, early pain control, sleep quality, and patient acceptability during 8% capsaicin patch therapy for thoracic PHN, while markedly reducing opioid rescue needs. These findings support TPVB-assisted capsaicin therapy as a promising multimodal strategy deserving evaluation in prospective controlled trials.