Greater Occipital Nerve Blockade in the Treatment of Tension-type Headaches in the Emergency Department

Abstract

Aim: This study aimed to tension-type headache (TTH) investigate the efficacy of greater occipital nerve (GON) blockade performed with dexketoprofen under ultrasonography in patients presenting to the emergency department. Materials and Methods: This prospective, randomized, controlled study was conducted with patients who presented to the emergency department with TTH. The treatment was planned as 50 mg of intravenous (IV) dexketoprofen over 5 min for Group 1 and IV dexketoprofen followed by ultrasonography-guided GON blockade with 0.5% bupivacaine for Group 2. The patients’ demographic characteristics and pain levels according to the 10-cm Visual Analog Scale were recorded at the time of presentation. The pain scores of the patients were recorded at the 10th, 20th, 30th, 60th, and 120th minutes, and the difference between the 0th and 120th minutes was calculated as the delta value. Results: Of the 159 patients included in the study. There was a decrease in the pain scores at the 10th minute in both groups with treatment, and the greatest decrease occurred in Group 2 at the 20th minute. The delta visual analog scale score was found to be 4.71 in Group 1 and 7.11 in Group 2, and it was observed that GON blockade therapy together with IV dexketoprofen reduced the severity of pain more rapidly and effectively than IV dexketoprofen alone. Conclusion: When managing acute pain attacks in patients presenting to the emergency department with TTH, the combined use of IV non-steroidal anti-inflammatory drugs with a GON block increases treatment outcomes, reduces treatment duration, and enhances the efficacy of analgesics compared with their use alone.

Keywords

• tension-type headache
• treatment
• non-steroidal anti-inflammatory drugs
• greater occipital nerve blockade