Occipital Nerve Blocks in the Emergency Department for Initial Medication-Refractory Acute Occipital Migraines

Author:

Yanuck Justin1,Shah Sagar1,Jen Maxwell1,Dayal Rakhi2

Affiliation:

1. University of California, Irvine, Department of Emergency Medicine, Orange, California

2. University of California, Irvine, Department of Anesthesiology, Orange, California

Abstract

Migraines are consistently among the top 20 primary coded diagnoses in emergency departments, constituting 4.5% of all chief complaints. In a significant subset of these, pain arises from the occipital region innervated by the greater (GON) and lesser occipital nerve. In this case series, we present three patients with occipital migraines who received GON blockade with 1% lidocaine. The blockade was performed only after first-line treatment with metoclopramide and possibly additional medications as ordered by triage physician, failed to adequately alleviate pain by 40 minutes after medication administration. Patients were contacted a minimum of seven days following treatment. All three patients experienced significant analgesia and relief of symptoms within 15 minutes of blockade and sustained relief through a seven-day follow-up period.

Publisher

Western Journal of Emergency Medicine

Subject

Emergency Nursing,Emergency Medicine

Cited by 2 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Acute migraine management in the emergency department: experience from a large Spanish tertiary hospital;Internal and Emergency Medicine;2021-03-12

2. Migraine;Pain Management for Clinicians;2020

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