{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:36:41Z","timestamp":1787017001036,"version":"build-2736575974"},"reference-count":17,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2021,10,2]]},"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The development of anterior hip neurolysis has made an appreciable impact on the management of patients with inoperable hip fracture. Nonetheless, suboptimal analgesic benefit was still observed in some patients. We therefore developed a novel posterior hip pericapsular neurolysis (PHPN) to complement anterior hip neurolysis in inoperable hip fracture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective review, we analyzed patients who responded suboptimally (defined as composite pain score moderate or higher on hip flexion 80\u00b0) to the anterior hip neurolysis from July 2019 to March 2021. The patients received additional PHPN if the composite pain score was suboptimal. The percentage of patients with dynamic composite pain scores on hip flexion to 80\u00b0\u2009and on gentle hip external and internal rotation on post-intervention day 5 was then evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 70\u2009patients who were reviewed in the study period, 20\u2009patients who partially responded to anterior hip neurolysis received an addition of diagnostic posterior hip pericapsular block. Eighteen patients were the positive responders and PHPN was then performed. Among the PHPN recipients, a high percentage with satisfactory dynamic pain control was observed with 78% on hip flexion 80\u00b0 and 83% on hip external\/internal rotation on day 5 following the intervention. No procedural adverse event was noted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>While most patients responded satisfactorily to anterior hip neurolysis, we concluded PHPN could be an effective adjunct to manage suboptimal pain control after anterior hip neurolysis in inoperable hip fracture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>NTWC\/REC\/21061.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rapm-2021-103023","type":"journal-article","created":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T10:56:40Z","timestamp":1634900200000},"page":"1080-1084","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Posterior hip pericapsular neurolysis (PHPN) for inoperable hip fracture: an adjunct to anterior hip pericapsular neurolysis"],"prefix":"10.1136","volume":"46","author":[{"given":"Tony Kwun-tung","family":"Ng","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Operating Theatre Services, Tuen Mun Hospital, Tuen Mun, Hong Kong"},{"name":"Center for Regional Anesthesia and Pain Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan"},{"name":"Department of Anaesthesiology, the University of Hong Kong, Pokfulam, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Peng","sequence":"additional","affiliation":[{"name":"Anesthesia, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wing-sang","family":"Chan","sequence":"additional","affiliation":[{"name":"Frankston Pain Management, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,10,22]]},"reference":[{"key":"2025101111114814000_46.12.1080.1","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1213\/XAA.0000000000000732","article-title":"Ultrasound-Guided Pericapsular hip joint alcohol neurolysis for the treatment of hip pain: a case report of a novel approach","volume":"11","author":"Sasaki","year":"2018","journal-title":"A A Pract"},{"key":"2025101111114814000_46.12.1080.2","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1213\/ANE.0000000000004172","article-title":"Chemical hip denervation for inoperable hip fracture","volume":"130","author":"Kwun-Tung Ng","year":"2020","journal-title":"Anesth Analg"},{"key":"2025101111114814000_46.12.1080.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2003.12.010"},{"key":"2025101111114814000_46.12.1080.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2005.05.020"},{"key":"2025101111114814000_46.12.1080.5","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1590\/S0080-623420150000500014","article-title":"[Pain intensity among institutionalized elderly: a comparison between numerical scales and verbal descriptors]","volume":"49","author":"Pereira","year":"2015","journal-title":"Rev Esc Enferm USP"},{"key":"2025101111114814000_46.12.1080.6","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afj058"},{"key":"2025101111114814000_46.12.1080.7","doi-asserted-by":"publisher","DOI":"10.1097\/00002508-200407000-00002"},{"key":"2025101111114814000_46.12.1080.8","doi-asserted-by":"publisher","DOI":"10.1097\/01.NOR.0000310607.62624.74"},{"key":"2025101111114814000_46.12.1080.9","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000707"},{"key":"2025101111114814000_46.12.1080.10","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000701"},{"key":"2025101111114814000_46.12.1080.11","doi-asserted-by":"crossref","first-page":"75","DOI":"10.5301\/HIP.2012.9042","article-title":"Characterisation and classification of the neural anatomy in the human hip joint","volume":"22","author":"Gerhardt","year":"2012","journal-title":"Hip Int"},{"key":"2025101111114814000_46.12.1080.12","article-title":"Sensory innervation of the hip joint and referred pain. A systemic review of the literature","volume":"10","author":"Pierre","year":"2021","journal-title":"Pain Med"},{"key":"2025101111114814000_46.12.1080.13","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-021-84345-z","article-title":"A systematic review and meta-analysis of the hip capsule innervation and its clinical implications","volume":"11","author":"Tomlinson","year":"2021","journal-title":"Sci Rep"},{"key":"2025101111114814000_46.12.1080.14","unstructured":"Nagpal AS , Brennick C , Occhialini AP . Innervation of the posterior hip capsule: a cadaver study. Pain Medicine 2021:1\u20138."},{"key":"2025101111114814000_46.12.1080.15","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1159\/000101965","volume-title":"The puzzle of orofacial pain. integrating research into clinical management","volume":"15","author":"Schaible","year":"2007"},{"key":"2025101111114814000_46.12.1080.16","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1002\/ejp.532","article-title":"Differential sensitization of silent nociceptors to low pH stimulation by prostaglandin E2 in human volunteers","volume":"19","author":"Namer","year":"2015","journal-title":"Eur J Pain"},{"key":"2025101111114814000_46.12.1080.17","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000195"}],"container-title":["Regional Anesthesia &amp; Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rapm-2021-103023","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T18:11:55Z","timestamp":1760206315000},"score":1,"resource":{"primary":{"URL":"https:\/\/rapm.bmj.com\/lookup\/doi\/10.1136\/rapm-2021-103023"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,22]]},"references-count":17,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2021,11,19]]},"published-print":{"date-parts":[[2021,12]]}},"alternative-id":["10.1136\/rapm-2021-103023"],"URL":"https:\/\/doi.org\/10.1136\/rapm-2021-103023","relation":{},"ISSN":["1098-7339","1532-8651"],"issn-type":[{"value":"1098-7339","type":"print"},{"value":"1532-8651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,22]]}}}