Efficacy of the Greater Occipital Nerve Block for Cervicogenic Headache: Comparing Classical and Subcompartmental Techniques

AimThe aim of the study was to compare the efficacy of the greater occipital nerve (GON) block using the classical technique and different volumes of injectate with the subcompartmental technique for the treatment of cervicogenic headache (CH). MethodsThirty patients acted as his/her own control. All patients were submitted to the GON block by the classical technique with 10mg dexamethasone, plus 40mg lidocaine (5mL volume). Patients were randomly allocated into 1 of 3 groups (n=10) when pain VAS was >3cm. Each group was submitted to a GON subcompartmental technique (10mg dexamethasone + 40mg lidocaine + nonionic iodine contrast + saline) under fluoroscopy using either 5, 10, or 15mL final volume. Analgesia and quality of life were evaluated. ResultsThe classical GON technique resulted in 2weeks of analgesia and less rescue analgesic consumption, compared to 24weeks after the subcompartmental technique (P<0.01). Quality of life improved at 2 and 24weeks after the classical and the suboccipital techniques, respectively (P<0.05). The data revealed that groups were similar regarding analgesia when compared to volume of injection (P>0.05). ConclusionsWhile the classical technique for GON block resulted in only 2weeks of analgesia, the subcompartmental technique resulted in at least 24weeks of analgesia, being 5mL volume sufficient for the performance of the block under fluoroscopy.