Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.02.037
Brazilian Journal of Anesthesiology
Case Report

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

Marcio V. Pimenta, Amanda T. Nakamura, Hermann S. Fernandes, Joaquim E. Vieira, Hazem A. Ashmawi

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Abstract

Introduction
Bone cancer metastasis may produce severe and refractory pain. It is often difficult to manage with systemic analgesics. Chemical neurolysis may be an effective alternative in terminally ill patients.

Case report
Female terminally ill patient with hip metastasis of gastric cancer in severe pain. Neurolytic ultrasound-guided blocks of the pericapsular nerve group and obturator nerve were performed with 5% phenol. This led to satisfactory pain relief for 10 days, until the patient's death.

Discussion
This approach may be effective and safe as an analgesic option for refractory hip pain due to metastasis or pathologic fracture in terminally ill patients.

Keywords

Regional anesthesia;  Pain management;  Chemical neurolysis; Hip;  Metastasis

References

[1] C. Christmas, C.J. Crespo, S.C. Franckowiak, J.M. Bathon, S.J. Bartlett, R.E. Andersen How common is hip pain among older adults? Results from the Third National Health and Nutrition Examination Survey J Fam Pract., 51 (2002), pp. 345-348

[2] P.W. Mantyh Bone cancer pain: from mechanism to therapy Curr Opin Support Palliat Care., 8 (2014), pp. 83-90

[3] L. Giron-Arango, P.W.H. Peng, K.J. Chin, R. Brull, A. Perlas Pericapsular Nerve Group (PENG) Block for Hip Fracture Reg Anesth Pain Med., 43 (2018), pp. 859-863

[4] T.D. Nielsen, B. Moriggl, K. Soballe, J.A. Kolsen-Petersen, J. Borglum, T.F. Bendtsen A Cadaveric Study of Ultrasound-Guided Subpectineal Injectate Spread Around the Obturator Nerve and Its Hip Articular Branches Reg Anesth Pain Med., 42 (2017), pp. 357-361

[5] T. Kwun-Tung Ng, W.S. Chan, P.W.H. Peng, P. Sham, S. Sasaki, H.F. Tsui Chemical Hip Denervation for Inoperable Hip Fracture Anesth Analg., 130 (2020), pp. 498-504

[6] A. Rocha Romero, G. Carvajal Valdy, A.J. Lemus Ultrasound-guided pericapsular nerve group (PENG) hip joint phenol neurolysis for palliative pain Can J Anaesth., 66 (2019), pp. 1270-1271
 

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