Postherpetic neuralgia (PHN) is the most frequent chronic complication of herpes zoster (HZ), the incidence of PHN gradually increases with age, and the persistent pain brings a heavy burden to patients with PHN. Virtual reality (VR) is an emerging tool for relieving acute and chronic pain. However, there is currently no research on applying VR to patients with PHN. This study aimed to explore the effectiveness and safety of VR in reducing the pain levels of patients with PHN. Providing an evidence-based medical rationale for the use of VR in pain management for patients with PHN. Fifty patients with PHN were randomly divided into the experimental group and the control group, with 25 cases in each group. The control group received PHN conventional therapy. The experimental group received VR therapy plus conventional therapy, namely 10-min VR sessions twice daily for five consecutive days (T1 T5). Primary outcome measure was patients reported pain levels at the sixth day after admission (T6). We also measured anxiety, depression and self-efficacy levels, as well as inflammatory factor levels of patients in both groups. Patients reported side effects and satisfaction in the experimental group were also recorded. Significant improvements were observed for pain (2.48 ± 1.23 vs 3.28 ± 1.37, P = 0.035), anxiety (31.44 ± 3.89 vs 33.72 ± 3.80, P = 0.041), depression (34.00 ± 5.91 vs 37.64 ± 5.02, P = 0.023), self-efficacy (32.68 ± 3.60 vs 29.92 ± 5.38, P = 0.038), IL-2 (3.30 ± 0.59 vs 2.67 ± 0.27, P<0.001), IL-6 (2.94 ± 1.38 vs 4.13 ± 2.43, P = 0.038), IL-10 (6.36 ± 1.03 vs 5.26 ± 1.09, P = 0.001), TNF-α (1.76 ± 0.48 vs 2.10 ± 0.59, P = 0.033), and INF-γ (3.82 ± 1.06 vs 3.00 ± 0.48, P = 0.001). No participants complained of severe side effects and patients’ satisfaction with VR reached 80
Butorphanol is sometimes added to multimodal intravenous patient-controlled analgesia (PCA), but its incremental analgesic benefit and adverse symptom burden when combined with an established sufentanil-based regimen remain uncertain. This single-center retrospective cohort study used routinely collected perioperative, postoperative PCA follow-up, and hospital billing data from July 2022 to June 2025. Patients who underwent gynecologic surgery and received one of four eligible base PCA regimens were included. Movement-evoked pain on postoperative day 1 was the primary effectiveness outcome, and any dizziness was the primary safety outcome. Propensity score overlap weighting was used for the primary analysis. The cohort included 1557 PCA treatment records, of which 239 contained butorphanol and 1318 did not. After overlap weighting, the adjusted mean differences were 0.01 points [95
This systematic review aimed to investigate neuraxial administration errors, examine their contributing factors, and evaluate clinical outcomes using a novel harm scale. The author searched PubMed, Web of Science, Scopus, EBSCOhost, and Google Scholar for reports from 1981 to 2025 in any language. Exclusions were reviews, overdose incidents, and non-neuraxial administrations. Harm was classified using a novel five-level scale, and contributing factors were identified using the Human and Systemic Factors Analysis Classification System (HFACS). The search revealed 50 reports (54 patients), mainly involving the epidural route (38 vs 16 intrathecal), non-obstetric patients (35 vs 17 obstetric), and female gender (73
Osteoarthritis (OA) is a leading cause of chronic pain and disability. Its increasing global prevalence and substantial socioeconomic burden highlights need for safer and more effective therapeutic strategies. Current pharmacological treatments provide symptomatic relief; however, are limited by gastrointestinal, cardiovascular, renal, and other adverse effects. Prostaglandin E2 (PGE2)-mediated EP4 receptor signaling plays a central role in OA pain, peripheral sensitization, subchondral bone remodeling, and cartilage degeneration, which makes EP4 an attractive therapeutic target. Current evidence suggests that KF-0210 is a potential therapy for OA pain and the present investigation summarizes pathophysiology of OA pain, the biological role of PGE2–EP4 signaling pathway, and the rationale for selective EP4 antagonism as a targeted alternative to conventional cyclooxygenase inhibition. Preclinical and clinical evidence for the oral EP4 antagonist KF-0210 is reviewed, including pharmacological properties, analgesic efficacy, safety profile, and potential disease-modifying mechanisms compared with existing OA therapies. Although the available evidence remains preliminary, selective EP4 antagonism represents a novel therapeutic strategy that requires further investigation.
Peripheral neuropathic pain (PNP) is a chronic condition that often requires long-term treatment. In 2025, the Neuropathic Pain Special Interest Group (NeuPSIG) updated its recommendations for treatment of neuropathic pain based on data from double-blind, randomized controlled trials (RCTs) with a duration of ≥ 3 weeks. To complement the existing body of evidence, we reviewed the long-term efficacy/safety of NeuPSIG-recommended treatments for PNP. We conducted a systematic literature review including clinical trials and observational studies of any design. Two literature searches were performed using PubMed and Embase (December 2024, May 2025). We included studies that enrolled ≥ 50 adult patients with PNP receiving ≥ 1 treatment recommended in the 2025 NeuPSIG guidance and with duration of ≥ 13 weeks. A supplemental search for long-term studies on high-concentration capsaicin 8
