Anesthesia Experts

Greater Occipital Nerve Block Effective for Acute Relief of Refractory Migraine

by Leave a Comment

In patients in which intravenous metoclopramide fails to relieve moderate or severe headache, greater occipital nerve block with bupivacaine may be an effective treatment, according to study results presented at the 2018 American Headache Society Annual Scientific Meeting, June 28-July 1, 2018, in San Francisco, California.

The randomized, 32-month study conducted in 2 urban emergency departments included 28 patients with acute moderate or severe migraine whose pain persisted for at least 1 hour post treatment with 10 mg intravenous metoclopramide. The patients were randomly assigned to receive either bilateral greater occipital nerve block with 6 cc 0.5% bupivacaine (n=13) or sham injection (n=15).

The primary outcome of headache freedom at 30 minutes post injection was achieved by 31% of patients in the treatment arm compared with none in the sham arm (95% CI, 6%-56%). Notably, 23% of patients in the treatment arm reported sustained headache relief for 48 hours post injection, compared with none in the sham group (95% CI, 0%-46%). The investigators noted that adverse effects were similar between both groups.

Greater occipital nerve block may be an effective and lasting treatment for patients whose acute migraine is not improved with standard care.

Reference

Friedman B, Mohamed S, Irizarry E, Robbins M. A randomized, sham-controlled trial of bilateral greater occipital nerve blocks with bupivacaine for acute migraine patients refractory to standard emergency department treatment with metoclopramide. Presented at: 2018 American Headache Society Annual Scientific Meeting. June 28-July 1, 2018; San Francisco, CA. Abstract 487904.

Leave a Reply

Call (660) 596-2224
What people thought about us

Testimonials

“As Director of Surgical Services Departments there has been considerable changes have occurred in my department and Anesthesia Experts has always risen to meet our demands of our facility. They have been very pro-active in meeting the increase volumes allowing us to keep our surgeons and patients very satisfied with our services.”

AR BSN 346 beds AL   

“Before AE took over the anesthesia department was described by the surgeons as the worst in the history of our hospital. The prior management company was having a cancelled surgery per day. I am happy to report there has not been one since they have taken over the department. Additionally we have seen a 905 reduction if requested preop
lab tests. The anesthesia department is now the very best hospital department in our entire facility.”

DS CEO 272 beds MS   

“Anesthesia Experts has provided consistent anesthesia providers who display a high degree of integrity, responsibility and professionalism. They have become a more valuable part of our facility and community.”

LR CEO 150 beds TX   

“Even though they are physically located 1000 miles away Anesthesia Experts just does not provide great anesthesia coverage they personally engage surgeons to increase their business. Last year my surgical volume rose by 24% and we are currently 50% ahead of last year and all of that growth is organic.”

JE FACHE CEO AL 92 bed hospital   

“Anesthesia Experts is more responsive than anyone I have dealt with. They are available by phone whenever needed and will be on site for any need or request and has been on site to address issues before we can make the request.”

SW CEO 25 beds NM   

“While problems are extremely rare when they do occur Anesthesia Experts quickly and professionally implements a solution. Our surgical volume has grown over 100 cases per month and now our GI docs want to perform all of their endoscopies in our hospital instead of their GI lab that they own!”

SP CEO 346 beds AL   

“Our anesthesia department was a thorn in my side that kept me awake at night. Anesthesia Experts swept in and brought order to our mess and our department was quickly redirected.”

JAM CNO AL 89 bed hospital   

Add a Testimonial

Verification Captcha