Ultrasound-guided bilateral greater occipital nerve block for the treatment of post-dural puncture headache.

Background and objectivePost-dural puncture headache (PDPH) is one of the complications frequently observed after spinal or epidural anesthesia with dural penetration. For PDPH patients who do not respond to conservative medical treatment, alternative treatments such as bilateral occipital nerve block should be considered.In this study the efficacy of bilateral occipital nerve block was retrospectively evaluated in patients with post-dural puncture headache.MethodsUltrasound-guided bilateral occipital nerve block was administrated in 21 patients who developed PDPH after spinal anesthesia, but did not respond to conservative medical treatment within 48 hours between January 2012 and February 2014. The study was conducted at Erzincan University Faculty of Medicine Gazi Mengucek Education and Research Hospital.ResultsMean Visual Analog Scale (VAS) pain scores at 10 minutes and 6, 10, 15 and 24 hours after the block were significantly improved compared to the patients with a pre-block VAS score between 4 and 6 as well as patients with a pre-block VAS score between 7 and 9 (pConclusionsFor patients with PDPH and a pre-block VAS score between 4 and 6 who do not respond to conservative medical treatment, an ultrasound-guided bilateral occipital nerve block may be effective.