Clinical practice guidelines for the management of refractory postherpetic neuralgia by the Korean Pain Society

作者：Kang HY, Lee CH, Kim DH, Kim YD, Kim WJ, Kim E, Kim JH, Kim HJ, Minn Y, Yang K, Oh J, Yoo Y, Lim SY, Jue MS, Choi EJ, Han K, Choi SS · 发表于：The Korean journal of pain · 年份：2026 · DOI：10.3344/kjp.25161 · 被引用次数：72 · 研究领域：Analgesics, Opioid、Anticonvulsants、Antidepressive Agents、Evidence-Based Medicine、Guideline、Health Planning Guidelines、Herpes Zoster、Nerve Block、Neuralgia, Postherpetic、Radiofrequency Ablation、Spinal Cord Stimulation

Postherpetic neuralgia (PHN) is persistent pain that occurs after the resolution of skin lesions caused by the reactivation of the herpes zoster virus. Several first-line agents, including anticonvulsants, tricyclic antidepressants, and lidocaine patches, are used in treatment. However, systematic, evidence-based, multidisciplinary clinical practice guidelines (CPGs) addressing the use of opioids and pain interventions-such as nerve blocks-for patients with refractory PHN unresponsive to first-line agents have not yet been established. Therefore, the Korean Pain Society, in collaboration with relevant medical specialty societies, has developed de novo CPGs for the management of refractory PHN. The development process followed Cochrane's systematic literature review methodology and employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system to assess the certainty of evidence and strength of recommendations. Key questions, identified through a survey of experts treating patients with refractory PHN, were finalized by the CPGs development panel. A literature search was conducted in four electronic databases: PubMed (MEDLINE), Embase, Cochrane Library, and KoreaMed. Studies were selected based on predefined inclusion and exclusion criteria using the population, intervention, comparison, outcomes, and study design (PICOS) framework. The resulting recommendations integrate evidence from the literature with patient and clinician preferences and va...