Which medications in the drug class Anesthetics are used in the treatment of Piriformis Syndrome?

Updated: Dec 21, 2018
  • Author: Shishir Shah, DO; Chief Editor: Sherwin SW Ho, MD  more...
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Answer

Anesthetics

The drugs of choice for local injection in painful piriformis syndrome include the anesthetic agents lidocaine and/or bupivacaine. Both are in the family of amide anesthetics. Use is based on the desired duration of action. Doses, as described below, are intramuscularly (IM) administered by identifying the trigger point. Be sure to aspirate first to avoid injecting the medication into a blood vessel.

Lidocaine HCL (Xylocaine, Dilocaine, Anestacon)

Amide anesthetic that stabilizes neuronal membrane by inhibiting ionic fluxes. Absorbed completely with parenteral administration. Metabolized by the liver. Unchanged metabolites are excreted by the kidneys. Half-life is typically 1.5-2 h. Lidocaine crosses blood-brain and placental barriers by passive diffusion. Indicated for regional and local anesthesia.

Bupivacaine Hydrochloride (Sensorcaine, Marcaine)

Amide anesthetic that blocks conduction of nerve impulses by inhibiting ionic fluxes. Absorbed completely with parenteral administration and metabolized by the liver. Unchanged metabolites are excreted by the kidneys. Half-life is typically 3-4 h and peak levels are achieved in 30-40 min. Bupivacaine crosses blood-brain and placental barriers by passive diffusion. Indicated for regional and local anesthesia.


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