Effectiveness of Hydro-Dissection of the Piriformis Muscle Plus Low-Dose Local Anesthetic Injection for Piriformis Syndrome: A Report of 2 Cases

2021 ◽  
Vol 23 ◽  
Author(s):  
Mihiro Kaga ◽  
Takeshi Ueda
Keyword(s):  
Local Anesthetic ◽  
Low Dose ◽  
Piriformis Syndrome ◽  
Piriformis Muscle ◽  
Local Anesthetic Injection

scholarly journals Piriformis Syndrome: Comparison of the Effectiveness of Local Anesthetic and Corticosteroid Injections: A Double-Blinded, Randomized Controlled Study

2015 ◽  
Vol 2;18 (2;3) ◽  
pp. 163-171 ◽  
Author(s):  
Tugce Ozekli Misirlioglu
Keyword(s):  
Local Anesthetic ◽  
Rating Scale ◽  
Small Sample ◽  
Controlled Study ◽  
Piriformis Syndrome ◽  
Piriformis Muscle ◽  
Randomized Controlled ◽  
Long Duration ◽  
Significant Difference ◽  
Double Blinded

Background: Piriformis syndrome (PS), which is characterized by pain radiating to the gluteal region and posterior leg, is accepted as one of the causes of sciatalgia. Although the importance of local piriformis muscle injections whenever PS is clinically suspected has been shown in many studies, there are not enough studies considering the clinical efficacy of these injections. Objective: To investigate the differences between local anesthetic (LA) and LA + corticosteroid (CS) injections in the treatment of PS. Study Design: A prospective, double-blinded, randomized controlled trial. Setting: Physical medicine and rehabilitation department of a university hospital. Methods: Fifty-seven patients having unilateral hip and/or leg pain with positive FAIR test and tenderness and/or trigger point at the piriformis muscle were evaluated. Out of 50 patients randomly assigned to 2 groups, 47 patients whose pain resolved at least 50% from the baseline after the injection were diagnosed as having PS. The first group (n = 22) received 5 mL of lidocaine 2% while the second group (n = 25) received 4 mL of lidocaine 2% + 1 mL of betametazone under the guidance of ultrasound. Outcome Assessment: Numeric Rating Scale (NRS) and Likert Analogue Scale (LAS). Results: No statistically significant difference (P > 0.05) was detected between the groups in NRS score values at resting (P = 0.814), night (P = 0.830), and in motion (P = 0.145), and LAS values with long duration of sitting (P = 0.547), standing (P = 0.898), and lying (P = 0.326) with evaluations at baseline, first week, and first and third months after the injection. A statistically highly significant (P < 0.005) reduction of pain was evaluated through NRS scores at resting (P = 0.001), in motion (P = 0.001), and at night (P = 0.001) and LAS values with long duration of sitting (P = 0.001), standing (P = 0.001), and lying (P = 0.001) in both of the groups. Limitations: Presumed limitations of this study include having a relatively small sample. Conclusion: LA injections for the PS were found to be clinically effective. However, addition of CS to LA did not give an additional benefit. This gives us the idea that PS is mostly muscular in origin and responds well to both LA and LA+CS injections. Key words: Piriformis muscle syndrome, injection, ultrasound, pain, local anesthetics, steroids, rehabilitation

Manual therapy and visual color-impulse therapy in the rehabilitation of patients with piriformis syndrome

2020 ◽  
pp. 95-101
Author(s):  
V. A. Frolov ◽  
M. S. Akopyan
Keyword(s):  
Manual Therapy ◽  
Muscle Tone ◽  
Randomized Study ◽  
Integrated Approach ◽  
Medical Rehabilitation ◽  
Piriformis Syndrome ◽  
Piriformis Muscle ◽  
Group I ◽  
Combined Use ◽  
Visual Color

Introduction. Piriformis syndrome (PS) is a condition accompanied by tension of the piriformis muscle and followed then by compression of the sciatic nerve passing through the piriformis muscle. According to statistics, PS occurs in 6–35 % of patients with lower back pain. Practitioners still face difficulties in treating patients with PS, and it necessitates the searching of new therapy methods and assessment of their compatibility.The goal of research — to study the clinical efficacy of the combined use of manual therapy and visual colorimpulse therapy in patients with piriformis syndrome.Materials and methods. A prospective, controlled, randomized study was conducted in 2019 at the Department of Sports Medicine and Medical Rehabilitation of I. M. Sechenov First Moscow Medical State University. In accordance with the inclusion criteria, 40 patients participated in the study. All participants, depending on the used treatment methodology, were divided by the method of simple randomization using envelopes into two equal groups. In the main group (group I), an integrated approach to treatment was tested: manual therapy in combination with visual color-impulse therapy (CIT); and in the other group (group II) only manual therapy was used.Results. The combined use of manual therapy and CIT in patients with piriformis syndrome leads to a significantly more pronounced decrease in the pain degree and normalization of impaired muscle tone. Also, an integrated approach helps to eliminate existing angiospastic disorders of the lower extremities.Conclusion. The study shows a clear positive dynamics in the integrated use of manual therapy methods in combination with visual color-impulse therapy in the treatment of patients with piriformis syndrome. It is planned to continue the study and assess the possibilities of using the combined technique in different groups of patients (athletes, pregnant women) with this syndrome. 

scholarly journals CORRELATION BETWEEN WONG-BAKER FACES PAIN SCALE AND SALIVARY ALPHA-AMYLASE LEVEL IN CHILDREN AGED 6–11 YEARS

2018 ◽  
Vol 9 ◽  
pp. 133
Author(s):  
Hastin Dian Anggraeni ◽  
Margaretha Suharsini ◽  
Ike Siti Indiarti ◽  
Faraghea Yumasdhika
Keyword(s):  
Pain Intensity ◽  
Local Anesthetic ◽  
Extraction Procedure ◽  
Pain Scale ◽  
Alpha Amylase ◽  
Primary Tooth ◽  
Amylase Level ◽  
Salivary Alpha Amylase ◽  
Local Anesthetic Injection ◽  
Spearman’S Correlation

Objective: Several studies have tried to objectively assess pain measurements. The Wong-Baker Faces Pain Scale (WBFPS) is an instrument that is commonly used to assess pain intensity in children. This study aimed to analyze the correlation between the WBFPS and salivary alpha-amylase (SAA) level during a tooth extraction procedure with a local anesthetic injection in children aged 6–11 years.Methods: Twenty-five children aged 6–11 years who were to undergo the extraction of a primary tooth at the Dental and Oral Educational Hospital, Faculty of Dentistry Universitas Indonesia, were enrolled in this study. From all children, saliva was collected using a disposable saliva strip shortly after local anesthetic injection, and the SAA activity was then determined using a portable Nipro Cocoro Meter device. The WBFPS was measured at the same time. The correlation between the WBFPS and the SAA level was analyzed using Spearman’s correlation test. The statistically significant level was set at p≤0.05.Results: There was a significant correlation between the WBFPS and SAA level (p=0.002, r=0.581).Conclusion: Our data suggest that the SAA level might be a good index for objective pain intensity assessment.

Pain Perception: Computerized versus Traditional Local Anesthesia in Pediatric Patients

2015 ◽  
Vol 39 (5) ◽  
pp. 470-474 ◽  
Author(s):  
M Mittal ◽  
A Kumar ◽  
D Srivastava ◽  
P Sharma ◽  
S Sharma
Keyword(s):  
Heart Rate ◽  
Local Anesthesia ◽  
Study Design ◽  
Local Anesthetic ◽  
Pain Perception ◽  
Pediatric Patients ◽  
Computerized Method ◽  
Local Anesthetic Injection ◽  
Computerized System ◽  
Buccal Infiltration

Background: Local anesthetic injection is one of the most anxiety- provoking procedure for both children and adult patients in dentistry. A computerized system for slow delivery of local anesthetic has been developed as a possible solution to reduce the pain related to the local anesthetic injection. Study design: The present study was conducted to evaluate and compare pain perception rates in pediatric patients with computerized system and traditional methods, both objectively and subjectively. Study design: It was a randomized controlled study in one hundred children aged 8-12 years in healthy physical and mental state, assessed as being cooperative, requiring extraction of maxillary primary molars. Children were divided into two groups by random sampling - Group A received buccal and palatal infiltration injection using Wand, while Group B received buccal and palatal infiltration using traditional syringe. Visual Analog scale (VAS) was used for subjective evaluation of pain perception by patient. Sound, Eye, Motor (SEM) scale was used as an objective method where sound, eye and motor reactions of patient were observed and heart rate measurement using pulse oximeter was used as the physiological parameter for objective evaluation. Results: Patients experienced significantly less pain of injection with the computerized method during palatal infiltration, while less pain was not statistically significant during buccal infiltration. Heart rate increased during both buccal and palatal infiltration in traditional and computerized local anesthesia, but difference between traditional and computerized method was not statistically significant. Conclusion: It was concluded that pain perception was significantly more during traditional palatal infiltration injection as compared to computerized palatal infiltration, while there was no difference in pain perception during buccal infiltration in both the groups

scholarly journals Evaluation of Changing Serum Blood Glucose Levels after Local Anesthetic Injection during Tooth Extraction

2015 ◽  
Vol 4 (2) ◽  
pp. 15-19
Author(s):  
Kamal Qaranizade ◽  
Eshagh Lasemi ◽  
Hamidreza Mahaseni Aghdam ◽  
Farshid Malihi ◽  
◽  
...  
Keyword(s):  
Blood Glucose ◽  
Local Anesthetic ◽  
Tooth Extraction ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Local Anesthetic Injection

A Novel Introducer for Ultrasound-Guided Cryoneurolysis Administration to Improve Patient Safety an d Functionality

2020 ◽  
pp. 217-220
Author(s):  
JOhn J. Finneran IV
Keyword(s):  
Peripheral Nerve ◽  
Postoperative Analgesia ◽  
Local Anesthetic ◽  
Improve Patient Safety ◽  
Femoral Nerve ◽  
Needle Insertion ◽  
Ultrasound Guided ◽  
Needle Pass ◽  
Time Required ◽  
Local Anesthetic Injection

Background: Percutaneous cryoneurolysis provides prolonged postoperative analgesia by placing a probe adjacent to a peripheral nerve and cooling the probe tip, inducing a reversible block that lasts weeks to months. Unfortunately, freezing the nerve can produce significant pain. Consequently, local anesthetic is generally applied to the nerve prior to cryoneurolysis, which, until now, required an additional needle insertion increasing both the risks and duration of the procedure. Case Presentation: Three patients underwent ultrasound-guided percutaneous cryoneurolysis of either the sciatic and saphenous nerves or the femoral nerve. In all patients, the local anesthetic injection and cryoneurolysis were accomplished with a single needle pass using the novel probe introducer. Conclusion: This introducer allows perineural local anesthetic injection followed immediately by cryoneurolysis, thereby sparing patients a second skin puncture, lowering the risks of the procedure, and decreasing the overall time required for cryoneurolysis. Key words: Cryoablation, cryoanalgesia, peripheral nerve block, postoperative analgesia, ultrasound

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