Greater occipital nerve block in the treatment of headaches. Review of evidence

Abstract

Introduction: Peripheral nerve blocks have been a common treatment for multiple headaches. By far, the greater occipital nerve block is the most used and with the stronger body of evidence in routine clinical practice.

Methods: We searched Pubmed Meta-Analysis/Systematic Review, in the last 10 years. Of these results, meta-analyses, and in the absence of these systematic reviews, assessing Greater Occipital Nerve Block in headache has been selected for review.

Results: We identified 95 studies in Pubmed, 13 that met the inclusion criteria.

Conclusion: Greater occipital block is an effective and safe technique, easy to perform and which has shown its usefulness in migraine, cluster headache, cervicogenic headache and Post-dural puncture headache. However, more studies are needed to clarify its long-term efficacy, its place in clinical treatment, the possible difference between different anaesthetics, the most convenient dosage and the role of concomitant use of corticosteroids.

Keywords: Anaesthesic block; Bloqueo anestésico; Cefalea cervicogénica; Cefalea en racimo; Cefalea tras punción lumbar; Cervicogenic headache; Cluster headache; Greater occipital nerve; Migraine; Migraña; Nervio occipital mayor; Post-dural puncture headache.