What is the role of anesthesia in the administration of piriformis injection?

Updated: Feb 28, 2019
  • Author: Mary Louise Caire, MD; Chief Editor: Erik D Schraga, MD  more...
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Answer

Piriformis injection is done with local anesthesia. Typically, 5 mL of 1% lidocaine is infiltrated into a skin wheal. As the needle is advanced, the remaining lidocaine is infiltrated along the path of the needle, as needed. (See Local Anesthetic Agents, Infiltrative Administration.)

Naja et al investigated whether clonidine-bupivacaine nerve-stimulator–guided injections are effective in achieving long-lasting pain relief in piriformis syndrome as compared with bupivacaine-guided injection. [9] Significantly lower pain scores and analgesic consumption were observed with bupivacaine-clonidine than with bupivacaine-saline. Additionally, pain at 6 months was significantly greater in the bupivacaine-saline group (78%) than in the bupivacaine-clonidine group (8%).

The procedure is done with the patient in a prone position.


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