Cervical Medial Branch and Third Occipital Nerve Blocks

2019 ◽  
pp. 157-167
Author(s):  
John-Paul B. Etheridge ◽  
Roderick Finlayson
Keyword(s):  
Medial Branch ◽  
Nerve Blocks ◽  
Occipital Nerve

Ultrasound-guided third occipital nerve and cervical medial branch nerve blocks

2009 ◽  
Vol 13 (3) ◽  
pp. 128-132 ◽  
Author(s):  
Andreas Siegenthaler ◽  
Samer Narouze ◽  
Urs Eichenberger
Keyword(s):  
Medial Branch ◽  
Ultrasound Guided ◽  
Nerve Blocks ◽  
Occipital Nerve

scholarly journals Sphenopalatine Ganglion versus Greater Occipital Nerve Blocks in Treating Post-Dural Puncture Headache after Spinal Anesthesia for Cesarean Section: A Randomized Clinical Trial

2021 ◽  
pp. E443-E451
Keyword(s):  
Cesarean Section ◽  
Dural Puncture ◽  
Sphenopalatine Ganglion ◽  
Ganglion Block ◽  
Nerve Blocks ◽  
Neck Stiffness ◽  
Post Dural Puncture Headache ◽  
Occipital Nerve ◽  
Greater Occipital Nerve ◽  
Blood Patch

BACKGROUND: Despite being invasive, with serious complications, epidural blood patch (EBP) is still considered the gold standard therapy for Post Dural Puncture Headache (PDPH). The use of Peripheral nerve blocks for PDPH are studied here. OBJECTIVES: To investigate the efficacy of sphenopalatine ganglion block (SPGB) and greater occipital nerve block (GONB) to relieve PDPH and its associated symptoms. STUDY DESIGN: Randomized comparative single-blind trial. SETTING: A University hospital. METHODS: Patients who received spinal anesthesia for elective cesarean section, and then developed PDPH during hospitalization or within 5 days after dural puncture were enrolled to receive GONB (n = 47) or SPGB (n = 46) for treatment of PDPH. GONB Group: Patients received bilateral GONB using 3 mL mixture of 2 mL lidocaine 2% plus 1 mL dexamethasone 4 mg on each side of occipital region. SPGB Group: Patients received bilateral SPGB using the same mixture in each nostril. Assessments included Numeric Rating Scale (NRS) for severity of headache at supine and sitting positions, nausea NRS, neck stiffness, need for EBP, and complications. RESULTS: The supine and sitting headache NRS scores significantly decreased at 30 minutes after blocks and throughout follow-up period in both groups (P < 0.000). Clinically significant drop of NRS to < 4 was reached earlier in GONB group. There was a significant difference between groups after 2 hours in supine and sitting headache NRS scores (P = 0.020 and 0.030, respectively); however, both treatments showed similar effectiveness from the third hour afterwards (P > 0.05). Both techniques were effective in relieving neck stiffness and nausea (P < 0.000), with no adverse effects. LIMITATIONS: A limitation to this study was the small sample size. CONCLUSIONS: GONB and SPGB are equally effective in relieving symptoms of PDPH. Both techniques are safe, simple, and less invasive than EBP. KEY WORDS: Cesarean Section, epidural blood patch greater occipital nerve block, post-dural puncture headache, sphenopalatine ganglion block

Role of Greater Occipital Nerve Blocks and Trigger Point Injections for Patients With Dizziness and Headache

2011 ◽  
Vol 17 (6) ◽  
pp. 312-317 ◽  
Author(s):  
Eric P. Baron ◽  
Neil Cherian ◽  
Stewart J. Tepper
Keyword(s):  
Trigger Point ◽  
Nerve Blocks ◽  
Occipital Nerve ◽  
Greater Occipital Nerve

Occipital Nerve Blocks for Relief of Headaches in Patients With Ventriculoperitoneal Shunts: A Case Series

2019 ◽  
Vol 34 (11) ◽  
pp. 674-678 ◽  
Author(s):  
Eugene Kim ◽  
Giovanni Cucchiaro
Keyword(s):  
Pediatric Patients ◽  
Case Series ◽  
Therapeutic Interventions ◽  
Shunt Revision ◽  
Occipital Neuralgia ◽  
Pulsed Radiofrequency ◽  
Nerve Blocks ◽  
Ventriculoperitoneal Shunts ◽  
Occipital Nerve ◽  
History Of

Pediatric patients with ventriculoperitoneal shunts commonly present with headaches. We report 7 children with ventriculoperitoneal shunts and occipital headaches who received occipital nerve blocks. Eighty-six percent of patients had a history of at least 1 ventriculoperitoneal shunt revision. Headaches improved in every patient after the block. Two patients (29%) were symptom free 11 and 12 months after the block. Four patients (57%) required repeat occipital nerve blocks. Two underwent pulsed radiofrequency ablation. No complications were noted. When patients with ventriculoperitoneal shunts present with headaches, a detailed physical examination is necessary. Persistent occipital headaches with tenderness and radiation in the path of the occipital nerves can be indicative of occipital neuralgia resulting from the shunt having crossed over the path of the greater or lesser occipital nerve. Occipital nerve blocks can help as both diagnostic and therapeutic interventions in these patients.

Cervical Intra-Articular Facet Injection: Computed Tomography

2016 ◽  
Author(s):  
Amaresh Vydyanathan ◽  
Karina Gritsenko ◽  
Samer N. Narouze ◽  
Allan L. Brook
Keyword(s):  
Pain Relief ◽  
Nerve Block ◽  
Local Anesthetic ◽  
Facet Joint ◽  
Medial Branch ◽  
Nerve Blocks ◽  
Articular Facet ◽  
Short And Long Term ◽  
Joint Injections

Intra-articular facet joint injections commonly refer to the injection of a contrast media and local anesthetic solution, with or without corticosteroids, directly into the facet joint space. The purpose of this procedure is pain relief as well as to establish an etiological diagnosis for surgical interventions such as joint denervation or radiofrequency ablation. Medial branch block, or facet nerve block, refers to injection of local anesthetic and possible corticosteroids along the medial branch nerve supplying the facet joints. Cervical intra-articular and facet nerve block injections are often part of a work-up for general or focal neck pain, headaches, or cervical muscle spasms. There is limited evidence for short- and long-term pain relief with cervical intra-articular facet joint injections. Cervical medial branch nerve blocks with local anesthetics demonstrate moderate evidence for short- and long-term pain relief with repeat interventions, and strong evidence exists for long-term pain relief following cervical radiofrequency neurotomy.

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