Ultrasound-guided pericapsular nerve group (PENG) hip joint phenol neurolysis for palliative pain

  • Andrés Rocha RomeroEmail author
  • Gabriel Carvajal Valdy
  • Angel Juarez Lemus

To the Editor,

Cancer pain requires multidisciplinary management, and in most cases sufficient pain relief is possible using systemic multimodal analgesia. Nonetheless, complex cases often require interventional pain management strategies. The pericapsular nerve group (PENG) block is a recently described ultrasound-guided regional anesthesia technique targeting sensitive nerves from the anterior articular capsule of the hip (articular obturator branches, accessory obturator nerve, and articular femoral nerve branches), thus limiting potential mixed nerve block and quadricep or adductor muscle weakness.1

We present an 82-yr-old female diagnosed with a pathological left hip fracture related to metastatic epidermoid carcinoma and associated deep vein thrombosis (DVT). The patient was using apixaban 2.5 mg po bid.She was referred to our pain service because of severe pain on her left hip that was 8/10 on a numeric rating scale limiting all basic activities (she was not able to sit). The...


Conflicts of interest

None declared.

Editorial responsibility

This submission was handled by Dr. Hilary P. Grocott, Editor-in-Chief, Canadian Journal of Anesthesia.


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Copyright information

© Canadian Anesthesiologists' Society 2019

Authors and Affiliations

  1. 1.Pain ClinicInstituto Nacional de CancerologíaMexicoMexico
  2. 2.Interventional Pain UnitCentro Nacional de Control del Dolor y Cuidados PaliativosSan JoséCosta Rica

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