Local anesthetics with multi modal analgesic minimally invasive surgery. In order to avoid opioids have quite negative effects on post operative rehabilitation. You see the thing. About opioids is it's all we have. And if it's audio have is what you'll use. And i often reflect. On the fact that with opioids the hall maze subtle. We all know the homes of anti-inflammatories yoni act ac- somebody have guest gaza. so once. And have matan missus for you to never forget that again. But we prescribe opioids because rarely do people actually refrige- arrests from them that we actually witness and it may be remote and linked to something else so often you know the eight year old falls over and gets attracted nickel. Fema comes into hospital and gets pneumonia and unfortunately dies. The cause of death is pneumonia. Fractured nickel fever. Nobody's talking about why she fell. And the reason she filed is because she's got twenty five grand final no patch on which was prescribed by well-meaning family physician or pain doctor. And you talk in the book. How there are some therapies that work for example for neuropathic pain there are some drugs that work and then talk a bit about nerve stimulators and how they can actually be very life changing for people so just very briefly. Can you talk about those interventions because it seems like there is some promise there so neuropathy pain is pain g to disease or injury of nerve either peripherally centrally and spinal cord stimulation has been around since the sixties and has got better and better and essentially leads are inserted in the epidurals space and the traditional type of spinal cord. Stimulation produces paris. Easier in the area of the new types of stimulators actually use a high frequency electrical current which stimulates population of inhibiting in the dorsal horn. And is probably the best treatment for peripheral neuropathic pain. The medications like governor pinton and try cyclic. Antidepressants have numbers needed. To treat of sort of one in six. A numbers needed to of one in eleven. They caused significant cognitive effects. But neuro modulation and spinal cord. Stimulation is an example of neuro. Modulation can provide.