Bloqueo anestésico del nervio occipital mayor en el tratamiento de las cefaleas. Revisión de la evidencia / Greater occipital nerve block in the treatment of headaches. Review of evidence

Introducción Los bloqueos anestésicos de nervios pericraneales han constituido un tratamiento habitual de múltiples cefaleas. El más utilizado en la práctica clínica habitual y que cuenta con mayor evidencia que avale su efectividad es el bloqueo del nervio occipital mayor. Métodos búsqueda en Pubmed de Meta-Analysis/Systematic Review de los últimos 10 años, seleccionando para su revisión aquellos metaanálisis, y en su defecto revisiones sistemáticas, acerca del bloqueo del nervio occipital mayor en el tratamiento de las cefaleas. Resultados Se obtuvieron 95 trabajos, 13 incluyeron los criterios de inclusión. Conclusión El bloqueo del occipital mayor es una técnica eficaz y segura, fácil de realizar, y que ha mostrado su utilidad en migraña, cefalea en racimos, cefalea cervicogénica y pospunción lumbar. No obstante, hacen falta más estudios que aclaren su eficacia a largo plazo, su lugar en el tratamiento habitual, la posible diferencia entre diversos anestésicos, la posología más conveniente y el papel del uso concomitante de corticoides (AU)

Introduction Peripheral nerve blocks have been a common treatment for multiple headaches. By far, the greater occipital nerve block is the most used and with the stronger body of evidence in routine clinical practice. Methods We searched Pubmed Meta-Analysis/Systematic Review, in the last 10 years. Of these results, meta-analyses, and in the absence of these systematic reviews, assessing Greater Occipital Nerve Block in headache has been selected for review. Results We identified 95 studies in Pubmed, 13 that met the inclusion criteria. Conclusion Greater occipital block is an effective and safe technique, easy to perform and which has shown its usefulness in migraine, cluster headache, cervicogenic headache and Post-dural puncture headache. However, more studies are needed to clarify its long-term efficacy, its place in clinical treatment, the possible difference between different anaesthetics, the most convenient dosage and the role of concomitant use of corticosteroids (AU)

[Greater occipital nerve block in the treatment of headaches. Review of evidence]. / Bloqueo anestésico del nervio occipital mayor en el tratamiento de las cefaleas. Revisión de la evidencia.

INTRODUCTION: Peripheral nerve blocks have been a common treatment for multiple headaches. By far, the greater occipital nerve block is the most used and with the stronger body of evidence in routine clinical practice. METHODS: We searched Pubmed Meta-Analysis/Systematic Review, in the last 10 years. Of these results, meta-analyses, and in the absence of these systematic reviews, assessing Greater Occipital Nerve Block in headache has been selected for review. RESULTS: We identified 95 studies in Pubmed, 13 that met the inclusion criteria. CONCLUSION: Greater occipital block is an effective and safe technique, easy to perform and which has shown its usefulness in migraine, cluster headache, cervicogenic headache and Post-dural puncture headache. However, more studies are needed to clarify its long-term efficacy, its place in clinical treatment, the possible difference between different anaesthetics, the most convenient dosage and the role of concomitant use of corticosteroids.