Patterns of anaesthetic pericranial nerve block in headache patients

Neurologia (Engl Ed). 2018 Apr;33(3):160-164. doi: 10.1016/j.nrl.2016.05.016. Epub 2016 Jul 25.
[Article in English, Spanish]

Abstract

Anaesthetic blocks, whether used alone or combined with other treatments, are a therapeutic resource for many patients with headaches. However, usage patterns by different professionals show significant heterogeneity.

Material and methods: The Headache Study Group of the Spanish Society of Neurology (GECSEN) designed a self-administered cross-sectional survey and sent it to all group members through the SEN's scientific area web platform in February 2016. The objective was to ascertain the main technical and formal aspects of this procedure and compare them with data obtained in a similar survey conducted in 2012.

Results: A total of 39 neurologists (mean age 41.74 years; SD: 9.73), 23 men (43.7 years; SD: 9.92) and 16 women (38.94 years; SD: 9.01) participated in this survey. Of these respondents, 76.9% used anaesthetic block in their clinical practice (79.16% in a tertiary-care hospital). The main indications were diagnosis and treatment of neuralgia (100%), prevention of chronic migraine (61.7%), episodic cluster headache (51.3%), and chronic cluster headache (66.7%). AB was used by 31% of the respondents to block only the lateral occipital complex, 13% also infiltrated the supraorbital nerve, and another 13% infiltrated the auriculotemporal nerve as well.

Conclusions: The indications for anaesthetic blocks and the territories most frequently infiltrated are similar to those cited in the earlier survey. However, we observed increased participation in this latest survey and a higher percentage of young neurologists (35.89% aged 35 or younger), indicating that use of this technique has entered mainstream clinical practice.

Keywords: Anaesthetic block; Bloqueo anestésico; Cefalea; Encuesta; Headache; Infiltración; Infiltration; Nervio pericraneal; Neuralgia; Pericranial nerve; Survey.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Anesthetics*
  • Cross-Sectional Studies
  • Female
  • Headache / therapy*
  • Humans
  • Male
  • Middle Aged
  • Migraine Disorders / therapy
  • Nerve Block / methods*
  • Neuralgia / therapy
  • Neurologists / statistics & numerical data
  • Neurologists / trends
  • Spain
  • Surveys and Questionnaires
  • Young Adult

Substances

  • Anesthetics