Ultrasound-guided bilateral greater occipital nerve block for the treatment of post-dural puncture headache

Abstract

Background and Objective:Post-dural puncture headache (PDPH) is one of the complications frequently observed after spinal or epidural anesthesia with dural penetration. For PDPH patients who do not respond to conservative medical treatment, alternative treatments such as bilateral occipital nerve block should be considered.In this study the efficacy of bilateral occipital nerve block was retrospectively evaluated in patients with post-dural puncture headache.Methods:Ultrasound-guided bilateral occipital nerve block was administrated in 21 patients who developed PDPH after spinal anesthesia, but did not respond to conservative medical treatment within 48 hours between January 2012 and February 2014. The study was conducted at Erzincan University Faculty of Medicine Gazi Mengucek Education and Research Hospital Results:Mean Visual Analog Scale (VAS) pain score at 10 minutes and 6, 10, 15 and 24 hours after the block were significantly improved compared to the patients with a pre-block VAS score between 4 and 6 as well as patients with a pre-block VAS score between 7 and 9 (p<0.01). After 24 hours of the block applied, VAS pain score dropped to 1 for all 12 patients who had a pre-block VAS score between 4 and 6. Whereas, VAS score decreased to 2 at 24 hours after the block in only one of the patients with a pre-block VAS between 7 and 9. For the patients with a pre-block VAS score between 7 and 9, there was no significant improvement in the mean VAS score 24 hours after the block.Conclusions:For patients with PDPH and a pre-block VAS score between 4 and 6 who do not respond to conservative medical treatment, an ultrasound-guided bilateral occipital nerve block may be effective.

Bilateral greater occipital nerve block for headache after corrective spinal surgery: a case report

“…BGON block was done using the anatomical landmarks but ultrasound-guided bilateral greater occipital nerve block has been described. 16 To our knowledge, there are no papers on the use of this block after corrective spinal surgery for scoliosis and our report suggests that a BGON block may be a successful alternative treatment for patients with PDPH. Further studies must be done to confirm that BGON block may be an effective treatment for patients with PDPH after corrective spinal surgery for scoliosis.…”

Ultrasound-guided bilateral greater occipital nerve block on headache seen after endovascular treatment of ruptured or unruptured intracranial aneurysms. A case report.

“…[24] Furthermore, the efficacy of the block also has been shown in the post-dural puncture headache. [25,26] We have emphasized in our study that one of the causes of the headache might be lumbar spinal drainage. In this case, we think that headache is caused by a similar mechanism with post-dural puncture headache.…”

Bilateral greater Occipital Nerve Block for Headache after corrective Spinal Surgery: A Case Report

“…BGON block was done using the anatomical landmarks but ultrasound-guided bilateral greater occipital nerve block has been described [16].…”