scholarly journals Occipital Nerve Blockade for the Treatment of Occipital Neuralgia-Like Acute Postcraniotomy Headache: A Retrospective Study

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Shaoheng Wang ◽  
Xueye Han ◽  
Chunmei Zhao ◽  
Fang Luo
Keyword(s):  
Pain Relief ◽  
Postoperative Recovery ◽  
Occipital Neuralgia ◽  
Drug Resistant ◽  
Nerve Blockade ◽  
Occipital Nerve ◽  
Oral Medications ◽  
Adequate Pain Relief ◽  
Medical Documents ◽  
Safe Technique

Objective. The therapeutic effectiveness and safety of occipital nerve blockade (ONB) on occipital neuralgia- (ON-) like acute postcraniotomy headache (ON-APCH) was evaluated. Background. Persistent occipital neuralgia is a subclassification of chronic postcraniotomy headache and has been investigated sporadically in previous publications. The long-lasting neuralgic pain significantly impairs postoperative recovery and quality of life. However, little is known regarding ON-APCH and its management. Methods. All data were retrospectively acquired from consultation records and electronic institutional medical documents. Forty-one patients, who developed drug-resistant ON-APCH after elective craniotomy and received ONB with lidocaine for diagnoses, were included in this study, all of whom were treated using dexamethasone and lidocaine. Pain intensity and ONB correlated complications and side effects were collected and analyzed at three different time points: before ONB, at 1 day after ONB, and at discharge. Results. Nineteen males and twenty-two females aged 49.6 ± 15.2 years were diagnosed with drug-resistant ON-APCH. The mean NRS was 8.0 ± 0.9 before ONB, which later significantly decreased to 2.1 ± 1.4 and 1.6 ± 0.6 at 1 day after ONB and on discharge, respectively. At 1 month after ONB, thirty patients (73%) obtained complete pain relief without medication. At 3 months after ONB, only two (5%) patients had to continue oral medications to maintain pain relief. No adverse effects or complications were observed immediately after, or within 3 months, of the nerve blockade. Conclusions. For drug-resistant ON-APCH, early occipital nerve blockade with dexamethasone and lidocaine is an effective and safe technique, which provides adequate pain relief and may prevent further development of persistent presentation of refractory ON.

Decompression of the Greater Occipital Nerve for Occipital Neuralgia and Chronic Occipital Headache Caused by Entrapment of the Greater Occipital Nerve

2022 ◽  
Author(s):  
Byung-chul Son
Keyword(s):  
Pain Relief ◽  
Rating Scale ◽  
Likert Scale ◽  
Pain Intensity Score ◽  
Occipital Neuralgia ◽  
Subjective Improvement ◽  
Occipital Nerve ◽  
Greater Occipital Nerve ◽  
Occipital Headache

Abstract Background Chronic entrapment of the greater occipital nerve (GON) can not only manifest in typical stabbing pain of occipital neuralgia (ON) but also lead to continuous ache and pressure-like pain in the occipital and temporal areas. However, the effect of GON decompression on these symptoms has yet to be established. We report the follow-up results of GON decompression in typical cases of ON and chronic occipital headache due to GON entrapment (COHGONE). Methods A 1-year follow-up study of GON decompression was conducted on 11 patients with typical ON and 39 COHGONE patients with GON entrapment. The degree of pain reduction was analyzed using the numerical rating scale-11 (NRS-11) score and percent pain relief before and 1 year after surgery. A success was defined by at least a 50% reduction in pain measured via NRS-11 during the 12-month follow-up. To assess the degree of subjective satisfaction, a 10-point Likert scale was used. Postoperative outcome was also evaluated using the Barrow Neurological Institute (BNI) pain intensity score. The difference in GON decompression between the patients with typical ON and those with COHGONE was studied. Results GON decompression was successful in 43 of 50 patients (86.0%) and percent pain relief was 72.99 ± 25.53. Subjective improvement based on a 10-point Likert scale was 7.9 ± 2.42 and the BNI grade was 2.06 ± 1.04. It was effective in both the ON and COHGONE groups, but the success rate was higher in the ON group (90.9%) than in the COHGONE group (84.6%), showing statistically significant differences in the results based on average NRS-11 score, percent pain relief, subjective improvement, and BNI grades (p < 0.05, independent t-test). Conclusion GON decompression is effective in chronic occipital headache and in ON symptoms induced by GON entrapment.

579 GREAT OCCIPITAL NERVE BLOCKADE (GONB) - INFILTRATION OF TRIGGER POINTS (TPS) OF CERVICAL MUSCLES IN PATIENTS (PTS) WITH OCCIPITAL NEURALGIA (ON)

2006 ◽  
Vol 10 (S1) ◽  
pp. S152b-S152
Author(s):  
I. Kouroukli ◽  
S. Xadjilia ◽  
V. Zobolas ◽  
T. Papavassilopoulou ◽  
A. Papadima ◽  
...  
Keyword(s):  
Trigger Points ◽  
Occipital Neuralgia ◽  
Great Occipital Nerve ◽  
Nerve Blockade ◽  
Occipital Nerve ◽  
Cervical Muscles

Dorsal root entry zone lesions for the treatment of post-herpetic neuralgia

1984 ◽  
Vol 60 (6) ◽  
pp. 1258-1262 ◽  
Author(s):  
Allan H. Friedman ◽  
Blaine S. Nashold ◽  
Janice Ovelmen-Levitt
Keyword(s):  
Pain Relief ◽  
Dorsal Root ◽  
Post Herpetic Neuralgia ◽  
Entry Zone ◽  
Dorsal Root Entry Zone ◽  
Content Type ◽  
Root Entry Zone ◽  
Adequate Pain Relief ◽  
Good Pain Relief ◽  
Transcutaneous Nerve Stimulation

✓ Post-herpetic pain was treated in 12 patients using dorsal root entry zone (DREZ) lesions. All patients had failed to receive adequate pain relief from conservative therapy consisting of transcutaneous nerve stimulation, carbamazepine, and/or amitriptyline. Dorsal root entry zone lesions were made to include the involved dermatomes plus one-half of the dermatomes above and below the painful areas. Eight patients reported good pain relief with follow-up periods ranging from 6 to 21 months. A ninth patient obtained satisfactory pain relief, but the superior 1 cm of the original painful area was not included in the distribution of the DREZ lesions. Patients whose lesions were performed using a thermally controlled lesion probe suffered no significant postoperative neurological deficit. Dorsal root entry zone lesions appeared to be a satisfactory treatment for post-herpetic neuralgia in patients who have failed to respond to more conservative modes of therapy.

scholarly journals Continuous Preperitoneal Infusion of Ropivacaine Provides Effective Analgesia and Accelerates Recovery after Colorectal Surgery

2007 ◽  
Vol 107 (3) ◽  
pp. 461-468 ◽  
Author(s):  
Marc Beaussier ◽  
Hanna El’Ayoubi ◽  
Eduardo Schiffer ◽  
Maxime Rollin ◽  
Yann Parc ◽  
...  
Keyword(s):  
Pain Relief ◽  
Colorectal Resection ◽  
Controlled Trial ◽  
Plasma Concentrations ◽  
Postoperative Recovery ◽  
Morphine Consumption ◽  
Major Surgery ◽  
Preperitoneal Space ◽  
Wound Infiltration ◽  
Open Colorectal Resection

Background Blockade of parietal nociceptive afferents by the use of continuous wound infiltration with local anesthetics may be beneficial in a multimodal approach to postoperative pain management after major surgery. The role of continuous preperitoneal infusion of ropivacaine for pain relief and postoperative recovery after open colorectal resections was evaluated in a randomized, double-blinded, placebo-controlled trial. Methods After obtaining written informed consents, a multiholed wound catheter was placed by the surgeon in the preperitoneal space at the end of surgery in patients scheduled to undergo elective open colorectal resection by midline incision. They were thereafter randomly assigned to receive through the catheter either 0.2% ropivacaine (10-ml bolus followed by an infusion of 10 ml/h during 48 h) or the same protocol with 0.9% NaCl. In addition, all patients received patient-controlled intravenous morphine analgesia. Results Twenty-one patients were evaluated in each group. Compared with preperitoneal saline, ropivacaine infusion reduced morphine consumption during the first 72 h and improved pain relief at rest during 12 h and while coughing during 48 h. Sleep quality was also better during the first two postoperative nights. Time to recovery of bowel function (74 +/- 19 vs. 105 +/- 54 h; P = 0.02) and duration of hospital stay (115 +/- 25 vs. 147 +/- 53 h; P = 0.02) were significantly reduced in the ropivacaine group. Ropivacaine plasma concentrations remained below the level of toxicity. No side effects were observed. Conclusions Continuous preperitoneal administration of 0.2% ropivacaine at 10 ml/h during 48 h after open colorectal resection reduced morphine consumption, improved pain relief, and accelerated postoperative recovery.

scholarly journals Occipital neuroma triggered cluster headache responding to greater occipital nerve blockade

2008 ◽  
Vol 66 (1) ◽  
pp. 74-76 ◽  
Author(s):  
Fabrizio Di Stani ◽  
Elcio Juliato Piovesan ◽  
Lorena Scattoni ◽  
Gianluca Bruti ◽  
Lineu Cesar Werneck
Keyword(s):  
Cluster Headache ◽  
Nerve Blockade ◽  
Occipital Nerve ◽  
Greater Occipital Nerve

scholarly journals Occipital Neuralgia Caused by an Intramuscular Lipoma. A Case Report

2020 ◽  
Vol 18 (1) ◽  
pp. 54-55
Author(s):  
Taluma Agnija ◽  
Griskjans Zans
Keyword(s):  
Computed Tomography ◽  
Histopathological Examination ◽  
Cervical Vertebrae ◽  
Headache Disorder ◽  
Occipital Neuralgia ◽  
Palpable Mass ◽  
Occipital Nerve ◽  
Intramuscular Lipoma ◽  
Patient Reported ◽  
The Right

SummaryOccipital neuralgia is a type of chronic headache disorder in the dermatomes of the greater or lesser occipital nerve. (7) We describe here a rare case of occipital neuralgia caused by an intramuscular lipoma. A 45 year-old man presented with troublesome pain in the occipital area with 3 x 2 cm palpable mass in the right occipital region. Patient was treated by a neurologist. The X ray for cervical vertebrae and computed tomography was performed.Computed tomography revealed a mass reminding intramuscular lipoma. Surgical management was indicated. During the operation stretching of the lesser occipital nerve was detected. After resection of lipoma on postoperative follow – up, the patient reported that the pain had resolved. During the histopathological examination, lipoma was confirmed.

scholarly journals Generalized tetanus in an 11-year-old boy: A case report

2021 ◽  
Vol 11 (1) ◽  
pp. 69-75
Author(s):  
Artem A. Kozlov ◽  
Irina V. Shevchuk ◽  
Aleksei E. Zavialov ◽  
Anatoly N. Emelyanov
Keyword(s):  
Case Report ◽  
Respiratory Failure ◽  
Gastrointestinal Tract ◽  
Pain Relief ◽  
Antibiotic Therapy ◽  
Clinical Course ◽  
Treatment Strategies ◽  
Adequate Pain Relief ◽  
Choice Of Treatment ◽  
Severe Tetanus

The study presents a case report of a generalized form of severe tetanus in an unvaccinated 11-year-old child. Pain and convulsive syndromes, respiratory failure, and damage to the gastrointestinal tract prevailed in the acute period. Antibiotic therapy, anti-tetanus serum, adequate pain relief, and anticonvulsant therapy were the leading treatments of the child. Moreover, the paper discusses literature data on the options for the clinical course and choice of treatment strategies. The lack of planned vaccination in children is unsafe.

Greater Occipital Nerve Decompression for Occipital Neuralgia

2018 ◽  
Vol 29 (5) ◽  
pp. e518-e521 ◽  
Author(s):  
Anson Jose ◽  
Shakil Ahmed Nagori ◽  
Probodh K. Chattopadhyay ◽  
Ajoy Roychoudhury
Keyword(s):  
Occipital Neuralgia ◽  
Occipital Nerve ◽  
Nerve Decompression ◽  
Greater Occipital Nerve

Intravenous ketamine as an analgesia in prehospital adult trauma patients

2022 ◽  
Vol 14 (1) ◽  
pp. 26-36
Author(s):  
Anya Critchley
Keyword(s):  
Pain Relief ◽  
Major Trauma ◽  
Trauma Patients ◽  
First Line ◽  
Exclusion Criteria ◽  
Adequate Pain Relief ◽  
Research Questions ◽  
Effective Pain Relief ◽  
Intravenous Ketamine

Background: Prehospital traumatic pain is common, but the quality of pain management in these patients is poor. Current practice recommends morphine as the first-line analgesia in major trauma but this carries high risks and is often contraindicated. Alternative paramedic-administered analgesia does not provide adequate pain relief or may be contraindicated. As a result, many patients remain in pain. Analgesic ketamine is used safely and effectively in international civilian and military settings and by paramedics with additional training, education and qualifications. Aim: The study had two aims. Namely, these were to find out whether intravenous ketamine: provides effective relief of prehospital traumatic pain in adults; and is safe for prehospital administration by non-specialist paramedics. Method: Three databases, CINAHL, MEDLINE and AMED, were searched to identify articles published between 2009 and 2021. Exclusion criteria were applied and results subjected to critical appraisal and evaluation. Findings: Four studies were included in the review. Two themes were identified for thematic analysis: therapeutic effectiveness; and the safety of IV ketamine administration by paramedics. The evidence drew predominantly homogenous conclusions, but was substandard regarding external validity, which limited the quality of these conclusions. Conclusion: Ketamine provides effective pain relief in line with morphine and is safe for paramedics to administer. However, clear gaps in the evidence mean the research questions are not fully answered, so changes to current paramedic practice cannot be recommended.

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