Adequate sedation for percutaneous musculoskeletal procedures requires a combination of patient information and reassurance, local anesthesia, and conscious sedation (1-4).
Local anesthetics are divided into ester-and amide-type agents. Ester agents include procaine, chloroprocaine, cocaine, and tetracaine. Amide-type agents include lidocaine, bupivacaine, mepivacaine, and etidocaine. Ester agents are hydrolyzed by plasma pseudocholinesterase. Amides undergo transformation through aromatic hydroxylation in the liver (3).