Efficacy of Ultrasound-Guided Multifidus Cervicis Plan Block Vs Greater Occipital Nerve Block for Cervicogenic Headache (UBLOC)
Cervicogenic Headache
About this trial
This is an interventional treatment trial for Cervicogenic Headache focused on measuring Cervicogenic Headache, Headache, Cervicis Plan Block, Occipital Nerve Block
Eligibility Criteria
Inclusion Criteria:
History of occipital nerve injection, occipital nerve stimulation or history of surgical procedures in the occipital region,
Exclusion Criteria:
- History of allergic reaction to the substance to be applied as local anesthetic.,
- Pregnancy or lactation,
- Uncontrolled hypertension,
- Uncontrolled diabetes mellitus,
- Uncompensated congestive heart failure,
- Chronic renal failure,
- Chronic liver disease,
- Tumor and/or vascular disease,
- Inflammatory and/or infectious diseases,
- Anticoagulant or antiplatelet medication use that may interfere with the injection process were also excluded.
Sites / Locations
- Mansoura University
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Greater occipital nerve block with ultrasound
Multifidus cervicis plane block with ultrasound guided
A-Greater occipital nerve block The ultrasound-guided GONB was performed to more accurately locate the nerve. The patient was asked to lie prone on the table. To locate the nerve, we searched for the occipital artery in the medial one-third of the superior nuchal line between the occipital tubercle and mastoid process. The scalp was cleaned with iodine. After that, the skin was sterilized, and the probe was sheathed in a sterile plastic package GONB was performed by applying the injection to the medial of the artery. A 22-gauge needle was advanced beneath the lateral border of the probe using real-time ultrasound guidance and an in-plane technique. In all patients the occipital nerve was seen medial to the artery. The injected side was determined by the patients' clinical symptoms and according to the painful side reported in their headache diaries. The patients were required to lie down for 30 minutes after the injection to avoid dizziness.
Patients placed in a lateral position with their affected side upwards. Several gel cushions were placed under their head, neck, and arm to put the neck in a stable and slightly anterior flexion position spinal level was determined by identifying the transverse process of the seventh and sixth cervical vertebrae (C7 and C6). The seventh cervical transverse process (C7) differs from the levels above by having a rudimentary anterior tubercle and a prominent posterior tubercle. After aseptic preparation of the injection area, lidocaine 1% was used to anesthetize the skin. Under continuous ultrasound guidance, the needle (22-G, 0.7 mm × 60 mm, Plexufx, B-BRAUN, Tokyo, Japan) was introduced in-plane through the skin and advanced into the fascial plane between the multifidus cervicis and semispinalis cervicis muscles for the MCP block.