Korean J Anesthesiol.  2011 Jul;61(1):50-54. 10.4097/kjae.2011.61.1.50.

Ultrasound-guided greater occipital nerve block for patients with occipital headache and short term follow up

• Shim JH
• Ko SY
• Bang MR
• Jeon WJ
• Cho SY
• Yeom JH
• Shin WJ
• Kim KH
• Shim JC

• KMID: 2092303
• DOI: http://doi.org/10.4097/kjae.2011.61.1.50

Abstract

BACKGROUND
The greater occipital nerve (GON) block has been frequently used for different types of headache, but performed with rough estimates of anatomic landmarks. Our study presents the values of the anatomic parameters and estimates the effectiveness of the ultrasound-guided GON blockade.
METHODS
The GON was detected using ultrasound technique and distance from external occipital protuberance (EOP) to GON, from GON to occipital artery and depth from skin to GON was measured in volunteers. Patients with occipital headache were divided into two groups (ultrasound-guided block: group S, conventional blind block: group B) and GON block was performed. The same parameters were measured on group S and VAS scores were assessed at pretreatment, 1 week and 4 weeks after treatment on both groups.
RESULTS
The GON had distance of 23.1 +/- 3.4 mm (right) and 20.5 +/- 2.8 mm (left) from EOP to GON. Its depth below the skin was 6.8 +/- 1.5 mm (right) and 7.0 +/- 1.3 mm (left). The distance from GON to occipital artery was 1.5 +/- 0.6 mm (right) and 1.2 +/- 0.6 mm (left) in volunteers. Initial VAS score of group S and group B patients were 6.4 +/- 0.2 and 6.5 +/- 0.2. VAS score of 4 weeks after injection were 2.3 +/- 0.2 on group S and 3.8 +/- 0.3 on group B (P = 0.0003).
CONCLUSIONS
The parameters measured in this study should be useful for GON block and ultrasound-guided blockade is likely to be a more effective technique than blind blockade in occipital headache treatment.

Keyword

Greater occipital nerve block; Occipital headache; Ultrasound; Visual analogue scale

MeSH Terms

Anatomic Landmarks
Arteries
Follow-Up Studies
Headache
Humans
Nerve Block
Skin