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CC BY-NC-ND 4.0 · Journal of Clinical Interventional Radiology ISVIR 2024; 08(01): 029-034
DOI: 10.1055/s-0044-1779257
Original Article

Ultrasound-Guided Occipital Nerve Block in the Management of Refractory Headache and Its Outcomes: A Prospective Study

Yashika Kalra
1   Department of Radiodiagnosis, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
,
Shailendra Singh Naik
2   Department of Radiodiagnosis, MNAMS, FVIR, Mediheal Group of Hospitals, Nairobi, Kenya
,
Arun Prakash Thangavelu
3   Department of Neurology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
,
Armel Arputha Sivarajan
1   Department of Radiodiagnosis, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
,
Sudhir Sachar
1   Department of Radiodiagnosis, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
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Abstract

Purpose Headache severely impacts health and lifestyle, causing distress and leading to accommodative changes in affected individuals. Treatment options available for refractory headache range from a conservative approach to advanced forms. The purpose of our study was to evaluate the effectiveness of ultrasound-guided occipital nerve block (ONB) in the management of refractory headaches using visual analog scale (VAS) score and Barrow Neurological Institute Pain Intensity Score (BNIPIS).

Methods A study sample of 30 eligible patients with refractory headaches including occipital neuralgia, migraine, tension headache, cluster headache, and vascular headaches aged between 18 and 65 years were included in our study. VAS and BNIPIS were noted for each patient before and after the procedure. ONB was given around the target nerve under aseptic precaution. Two milliliters of 0.5% bupivacaine was used as an injection solution for all patients.

Results The mean VAS score in acute pain at pre-treatment and post-treatment after 24 hours and 3 months was found as 7.53, 1.53, and 3.20, whereas in chronic pain the score was 8.13, 3.07, and 5.87, respectively. Pre-treatment pain levels in acute and chronic subjects in BNIPIS IV and V category shifted to category I and II after 24 hours (postinjection) that later were recorded II and III, respectively, after 3 months.

Conclusion Standard treatment guidelines are given by the international headache association for the management of headaches. The use of ONB is well advocated and practiced for a long time. In our study, we found that the use of greater occipital nerve block reduced pain levels affecting VAS and BNIPIS, which was more effective in acute cases than in chronic cases.

Keywords

occipital nerve block - visual analog scale - Barrow Neurological Institute Pain Intensity Score

Ethical Approval

The study was reviewed by Mahatma Gandhi Medical College & Research Institutional Ethics Committee and was certified that it represented an accurate and complete description of the proposed research. The study was performed as per the approved protocol only.


Presentation at a Meeting

Organization: Department of Radiodiagnosis and Department of Neurology


Place: Mahatma Gandhi Medical College & Research Institute


Date: 23–11–2022




Publication History

Article published online:
01 March 2024

© 2024. Indian Society of Vascular and Interventional Radiology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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