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Background and Aims Chronic hip pain due to osteoarthritis significantly impairs quality of life, and conventional treatments often provide inadequate relief. Ultrasound-guided pericapsular nerve group (PENG) neurolysis with ethanol is a minimally invasive technique that may offer prolonged analgesia. This study evaluated the efficacy and safety of ultrasound-guided 95% ethanol neurolysis of the PENG compared to a sham procedure in patients with chronic hip pain.Methods This double-blind, single-center, randomized controlled trial ( NCT06087588) was approved by the Bioethics Committee of Poznan University of Medical Sciences on March 9, 2023 (protocol number 224/23) and registered at ClinicalTrials.gov on October 17, 2023, before recruitment. The study was conducted in accordance with the Declaration of Helsinki and followed the Consolidated Standards of Reporting Trials (CONSORT) guidelines. A total of 100 patients with chronic hip pain unresponsive to conservative treatments were randomly assigned to either ethanol neurolysis (n=50) or a sham procedure (n=50). The primary outcome was pain intensity, assessed using the Numeric Rating Scale (NRS) at 7 days, 30 days, 3 months, and 6 months. Secondary outcomes included opioid consumption (oral morphine equivalents), quality of life (EQ-5D-5L), and neurological deficits.Results Ethanol neurolysis significantly reduced NRS scores at all follow-ups (p < 0.0001). Opioid consumption was lower in the neurolysis group at 7 days (11.8 ± 5.1 mg vs. 1.6 ± 2.4 mg, p < 0.0001) and remained reduced through 6 months (p < 0.0001). Quality of life improved significantly (p < 0.0001), and no neurological deficits were observed.Conclusions Ultrasound-guided ethanol neurolysis of the PENG is a safe and effective intervention for chronic hip pain, providing long-term relief and reducing opioid dependency. Further multicenter trials are needed to validate long-term outcomes.Abstract OP10 Table 1Primary outcomesAbstract OP10 Table 2Secondary outcomesAbstract OP10 Table 3Health questionnaire – EQ-5D-5L