APPROACH WITH ULTRASOUND-GUIDED PIRIFORMIS BLOCKS FOR PAIN RELIEF AND CONFIRMATION OF THE CLINICAL DIAGNOSIS OF DEEP GLUTEAL PAIN

Abstract

OBJECTIVE: The objective of this study was to demonstrate the clinical efficacy in immediate pain improvement after the ultrasound-guided puncture procedure, followed by infiltration and administration of lidocaine and betamethasone in the piriformis muscle belly. MATERIALS AND METHODS: This retrospective and comparative study used ultrasound equipment for the punctures together with a medical tuning fork and a power Doppler. Data analysis of the last 500 cases of echo-guided procedures was performed in a reference clinic in the city of Goiânia-GO. Among these cases, ultrasound reports that contained data related to deep gluteal pain (piriformis syndrome) were selected. The following information was analyzed: age, sex, laterality and confirmation of pain improvement using the visual analog scale (VAS). All patients underwent piriformis block with ultrasound-guided puncture, followed by infiltration and administration of 2% lidocaine, without vasoconstrictor, 6ml and betamethasone dipropionate (5mg / mL) + betamethasone disodium phosphate (2mg / mL). RESULTS: Of the 500 procedures, 53 were related to deep gluteal pain (Piriformis Syndrome). The average age of the patients was 58 years old, being the youngest patient 21 years old and the oldest 84 years old. As for sex, there were 11 male patients, which corresponds to 21% of the cases and 42 females, which corresponds to 79% of the cases. As for laterality, the left side was the one that appeared most frequently, with 70%, which is equivalent to 37 patients. The right side affected only 14 patients, corresponding to 26% of the cases. In addition, in two patients the involvement was bilateral, which is equivalent to 4% of cases. CONCLUSION: The echo-guided block in the piriformis muscle belly proved to be effective for diagnostic confirmation and treatment of pain relief in deep gluteal pain syndrome, with 100% of cases showing pain relief between 0 and 3 in the VAS (Visual Analog Scale) of 0 to 10. With the female sex being the most frequent, with an average age from both sexes of 58 years and prevalence of 70% of cases on the left side.