Ultrasound-guided pericapsular nerve group and obturator nerve phenol neurolysis for refractory inpatient hip cancer metastasis pain: a case report

Pimenta, Marcio V.; Nakamura, Amanda T.; Ashmawi, Hazem Adel; Vieira, Joaquim Edson

doi:10.1016/j.bjane.2021.02.037

Cited by 6 publications

(5 citation statements)

References 4 publications

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“…In a case report, the PENG block was given with 20 mL 0.25% bupivacaine and 8 mg dexamethasone, and provided pain relief for 2 weeks in chronic hip pain due to OA [36]. In addition, some anecdotal cases have been reported on the effective use of pulsed radiofrequency of PENG and the neurolytic PENG block for chronic pain treatment [16,17,36,37]. According to the present results, there was a significant effect from the PENG block for two months, in addition to the greatest effect occurring on day one due to the nerve blockade with LA that was present in the PENG block.…”

Section: Pre-treatmentmentioning

confidence: 99%

“…The pericapsular nerve group (PENG) block is an interfascial plane block for the blockade of sensory nerve branches including the articular branches of the femoral (FN), obturator (ON), and accessory obturator (AON) nerves to the anterior hip capsule, with the limitation of quadriceps or adductor muscle weakness. Then the use of the PENG block was expanded by applying it for the management of hip OA [15][16][17].…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound-guided PENG block versus intraarticular corticosteroid injection in hip osteoarthritis: a randomised controlled study

Köse

Köse²,

Çelikel

et al. 2023

Korean J Pain

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Background: This study aimed to compare the effectiveness of the pericapsular nerve group (PENG) block and intra-articular injection (IAI) of steroid-bupivacaine in the treatment of hip osteoarthritis (OA). Methods: After randomization, patients received either a PENG block or IAI under ultrasound-guidance. Clinical evaluations were recorded at baseline, day 1, and weeks 1, 4, and 8 post-intervention. The numerical rating scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Harris Hip Scale (HHS) scores, pain medication use determined by a quantitative analgesic questionnaire, and patient satisfaction were evaluated. Results: Sixty patients were included in this study. NRS scores improved significantly for both groups during the follow-up compared to pretreatment (P < 0.001), with better pain scores for the PENG group (P < 0.001) at day 1 with larger effect size (Cohen's d = 4.62), and IAI group at 4 (Cohen's d = 5.15) and 8 (Cohen's d = 4.33) weeks (P < 0.001). There was no significant difference in pain medication consumption (P = 0.499) and patient satisfaction (P = 0.138) between groups. Patients in the IAI group experienced significant improvement in HHS (Cohen's d = 2.16, P = 0.007) and WOMAC (Cohen's d = 1.02, P = 0.036) scores at 8 weeks compared to the PENG group. Conclusions: The ultrasound-guided PENG block provides effective pain relief which improves functionality and quality of life in hip OA patients up to 2 months. The PENG block can be considered an easy, safe, and useful alternative treatment modality for hip OA.

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Section: Pre-treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ultrasound-guided PENG block versus intraarticular corticosteroid injection in hip osteoarthritis: a randomised controlled study

Köse

Köse²,

Çelikel

et al. 2023

Korean J Pain

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“…The authors reported that all patients experienced adequate analgesia within 30 min of PENG block, improving their range of motion of the hip with little or no pain. Pimenta et al [14 ▪ ] reported a case of UG PENG and obturator nerve neurolysis with 5% phenol for a patient with refractory hip pain who had been diagnosed with gastric cancer and had bone metastasis in the right femoral head. They reported that phenol was their choice as it was less painful, compared to 99% ethanol.…”

Section: Chronic Pain Of the Hip Jointmentioning

confidence: 99%

New ultrasound-guided techniques in chronic pain management: an update

Ergönenç

Stockman

2021

Current Opinion in Anaesthesiology

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Purpose of reviewThe introduction of ultrasound guidance in interventional pain management leads to the development of new interventional pain management techniques. Ultrasound-guided (UG) interventional pain management is rapidly developing and increasingly more commonly used, due to its many advantages over traditional radiologic imaging modalities. This review will summarize recent literature around novel interventional pain techniques with ultrasound guidance published over the last 18 months. Recent findingsMany new interventional pain management methods have been described in the last few years in the literature. The use of ultrasonography in interventional pain management played a crucial role in these developments. This review includes newly described interventional methods in the literature. The review particularly focussed on the methods that are used to treat the pain in the hip, shoulder, knee, and lumbar area. These new techniques hold promise for significant improvements in the efficacy and safety of interventional pain management.

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“…Hip pain is a common and incapacitating symptom among adults aged 60 and older [ 1 ]. Infection, aortoiliac insufficiency, and bone metastasis are rare causes of hip pain [ 1 ]. Prostate cancer incidence and mortality also correlate with old age [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…In advanced stages of metastasis, it can travel to the lungs, liver, pleura, and adrenal glands [ 4 ]. Although it is uncommon, bone metastasis can lead to chronic and disabling hip pain [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Prostate Cancer Presenting as Hip Pain at the Chiropractic Office: A Case Report and Literature Review

Chu¹,

Lee²

2023

Cureus

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Prostate cancer is one of the most common cancers found in males, and it tends to metastasize to bony parts such as the hip, spine, and pelvis, resulting in pain and/or radicular pain, which can present similarly to musculoskeletal complaints. The lack of routine screening and musculoskeletal symptoms present challenges in the diagnosis of prostate cancer.We report the case of a 62-year-old male with no history of cancer and no previous prostate cancer screening who visited a chiropractor for the care of worsening left hip pain after a marathon. The patient visited other healthcare providers and was suggested to have degenerative conditions; he received nonsteroidal anti-inflammatory medication, physiotherapy, and acupuncture. Given the patient's limited improvement by other providers and neurological symptoms, the chiropractor requested lumbar spine radiography, which revealed suspected bone metastasis, and ordered a hip MRI accordingly. MRI findings suggested prostate cancer, and the chiropractor referred the patient to an oncologist, who performed additional imaging and testing to make a presumptive prostate cancer diagnosis. A literature search found nine cases of undiagnosed prostate cancer presenting to a chiropractor for care. All patients included in this case were older males with no previous prostate screening or bone metastasis.The study is focused on the need for a comprehensive evaluation of patients with hip pain during a chiropractic visit due to the chances of prostate cancer. There are higher chances of ignoring cancer symptoms during a hip examination. Comprehensive evaluation and advanced imaging could help chiropractors detect patients with prostate cancer.

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Ultrasound-guided pericapsular nerve group and obturator nerve phenol neurolysis for refractory inpatient hip cancer metastasis pain: a case report

Cited by 6 publications

References 4 publications

Ultrasound-guided PENG block versus intraarticular corticosteroid injection in hip osteoarthritis: a randomised controlled study

Ultrasound-guided PENG block versus intraarticular corticosteroid injection in hip osteoarthritis: a randomised controlled study

New ultrasound-guided techniques in chronic pain management: an update

Prostate Cancer Presenting as Hip Pain at the Chiropractic Office: A Case Report and Literature Review

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