Novel Ultrasound-Guided Sub-Piriformis Injection (SPI) May Produce Effective Analgesia for Both Open and Arthroscopic Hamstring Repair: A Case Report

Open or arthroscopic repair of hamstring tear requires both hard and soft, posterior and proximal thigh analgesia. Regional injections to completely relieve this unique pain are not available to the best of our knowledge. We present a novel, single injection, performed under ultrasound guidance, that utilizes the deep piriformis space. This space contains multiple nerves involved in the surgery and can be completely anesthetized with only 10 ml of local anesthetic. We further extended the block for a total of 80 hours through the use of liposomal bupivacaine.