Usefulness of anesthetic block of the greater occipital nerve in the treatment of migraine in children and adolescents.

INTRODUCTION

Peripheral nerve blockade (PNB) is a common treatment in adults with headache. Although there is little evidence in pediatrics, its simplicity, safety and efficacy make it an option that can be extrapolated to our practice. Therefore, we conducted a study in which we evaluated the usefulness of anesthetic blockade of the NOM (greater occipital nerve) as a treatment for migraine in the pediatric population.

METHODS

Prospective cohort study in children and adolescents with migraine. We collected demographic and clinical data (pain intensity using the verbal numeric scale) and data related to quality of life (PedMidas and PedsQL questionnaire) at baseline and after performing NOM block with 2.5 ml of 0.5% bupivacaine.

RESULTS

We included 28 patients (89.3% women) with a mean age of 13.9 years. Mean frequency of 22.8 episodes/month and intensity of 7.7/10 on the verbal-numerical scale (VNS). Post-treatment: significant reduction (P < .01) in frequency to 6.1 episodes/month and intensity: 3.9 points (30 minutes), 4.2 points (1 week), 3.9 points (15 days), 4.4 points (1 month) and 5.4 points (3 months). 100% had an effect on their quality of life, both on the PedMidas and PedsQL scales, the greater the effect, the better the response. Only 2 had adverse effects (syncope and local pain).

CONCLUSIONS

NOM blockade is a safe, effective and useful procedure for the acute and preventive treatment of migraine in pediatric age. It relieves the burden associated with headache and is associated with an improvement in the quality of life of patients.