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Treatment of cancer pain is generally based on the three-step World Health Organization (WHO) pain relief ladder, which utilizes a sequential approach with drugs of increasing potency. Goals of pain management include optimization of analgesia, optimization of activities of daily living, minimization of adverse effects, and avoidance of aberrant drug taking. In addition, it is recommended that analgesic regimens are individualized and simplified to help ensure patient compliance and should provide the least invasive, easiest, and safest route of opioid administration to ensure adequate analgesia. Buprenorphine and fentanyl are two opioids available for the relief of moderate-to-severe cancer pain. Available clinical data regarding the transdermal (TD) formulations of these opioids and the extent to which they fulfill the recommendations mentioned earlier are systematically reviewed, with the aim of providing additional information for oncologists and pain specialists regarding their comparative use. Due to lack of studies directly comparing TD buprenorphine with TD fentanyl, data comparing these with other step-3 opioids are also evaluated in a network fashion., Video abstract

Objectives: Several studies have demonstrated the advantages of epiduroscopy versus conservative therapies for low back pain with few studies evaluating the results in operated and non-operated back patients. We compared the effects and complications of epiduroscopy between these patients. Patients and methods: A multi-institutional, prospective, clinical study was performed in 183 patients whose low back and leg pain had failed to respond to conservative therapies. Patients were divided into an operated back (Op) group and a non-operated (Non-op) group. Japanese Orthopedic Association (JOA) score, the Japanese version of the Roland-Morris Disability Questionnaire (JRMDQ) scores, and 100-mm visual analogue scales (VAS) for leg pain, leg numbness, low back pain and dissatisfaction with ADL were recorded before and at 1 month and 3 months after epiduroscopy. Results: All scores significantly improved at 1 month and 3 months after epiduroscopy in both groups. JOA scores in the Non-op group were sign...