Efficacy of the Greater Occipital Nerve Block for Cervicogenic Headache: Comparing Classical and Subcompartmental Techniques.

Abstract

AIM:

The aim of the study was to compare the efficacy of the greater occipital nerve (GON) block using the classical technique and different volumes of injectate with the subcompartmental technique for the treatment of cervicogenic headache (CH).

METHODS:

Thirty patients acted as his/her own control. All patients were submitted to the GON block by the classical technique with 10 mg dexamethasone, plus 40 mg lidocaine (5 mL volume). Patients were randomly allocated into 1 of 3 groups (n = 10) when pain VAS was > 3 cm. Each group was submitted to a GON subcompartmental technique (10 mg dexamethasone + 40 mg lidocaine + nonionic iodine contrast + saline) under fluoroscopy using either 5, 10, or 15 mL final volume. Analgesia and quality of life were evaluated.

RESULTS:

The classical GON technique resulted in 2 weeks of analgesia and less rescue analgesic consumption, compared to 24 weeks after the subcompartmental technique (P < 0.01). Quality of life improved at 2 and 24 weeks after the classical and the suboccipital techniques, respectively (P < 0.05). The data revealed that groups were similar regarding analgesia when compared to volume of injection (P > 0.05).

CONCLUSIONS:

While the classical technique for GON block resulted in only 2 weeks of analgesia, the subcompartmental technique resulted in at least 24 weeks of analgesia, being 5 mL volume sufficient for the performance of the block under fluoroscopy.

• Authors: Gabriela R Lauretti, Selma W R O Corrêa, Anita L Mattos
• Journal: Pain practice : the official journal of World Institute of Pain (Pain Pract) Vol. 15 Issue 7 Pg. 654-61 (Sep 2015) ISSN: 1533-2500 [Electronic] United States
• PMID: 24995659 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: © 2014 World Institute of Pain.

Chemical References

• Anesthetics, Local
• Lidocaine

Topics

• Adult
• Anesthetics, Local (administration & dosage)
• Autonomic Nerve Block (methods, standards)
• Female
• Humans
• Lidocaine (administration & dosage)
• Male
• Middle Aged
• Pain (complications, diagnosis)
• Pain Management (methods, standards)
• Pain Measurement (methods, standards)
• Post-Traumatic Headache (complications, diagnosis, therapy)
• Quality of Life
• Spinal Nerves
• Treatment Outcome