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To treat occipital neuralgia like acute
postcraniotomy headache (ON-APCH), early occipital
nerve blockade with lidocaine and dexamethasone was
found to be an effective and safe approach.
Early occipital nerve blockade with lidocaine and dexamethasone is a safe and effective choice for managing patients with drug-resistant ON-APCH. It minimizes pain and may prevent the development of refractory occipital neuralgia, says a retrospective study published in "Pain Research and Management". Shaoheng Wang et al. undertook this study to explore the therapeutic efficacy and safety of occipital nerve blockade on ON-APCH.
The data were retrospectively collected from electronic institutional medical documents and case records (from January 2012 and December 2020). In total, 41 subjects having drug-resistant ON-APCH after elective craniotomy and were given occipital nerve blockade with lidocaine for diagnoses were enrolled in the trial. All the subjects were treated with lidocaine and dexamethasone.
The intensity of pain and occipital nerve blockade-linked complications and adverse effects were examined at different time points: (i) prior to occipital nerve blockade, (ii) at one day after occipital nerve blockade, and (iii) at discharge. It was noted that the mean NRS before occipital nerve blockade declined considerably after occipital nerve blockade and at discharge, as shown in the table below:
After one month, complete pain alleviation without medicines was noted in 73% of patients (n=30) whereas, after three months, only 5% (n=2) patients had to continue oral medications for maintaining pain relief. As such, there were no side effects or complications noted instantly after or within three months of nerve blockade.
Thus, the
authors conclude that the occipital nerve blockade approach can safely and
effectively alleviate pain, and also prevent the development of refractory occipital neuralgia.
Pain research and Managment
Occipital Nerve Blockade for the Treatment of Occipital Neuralgia-Like Acute Postcraniotomy Headache: A Retrospective Study
Shaoheng Wang et al.
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