Greater Occipital Nerve Block With Bupivacaine for Acute Migraine

Montefiore Medicine Academic Health System

Status and phase: Completed; Phase 3

Conditions: Migraine

Treatments: Procedure: Greater occipital nerve block; Drug: Bupivacaine

Study type: Interventional

Funder types: Other

Identifiers

NCT02665273

2015-4754

Details and patient eligibility

About

This is a randomized, sham-controlled study of greater occipital nerve block (GONB) using bupivacaine 0.5% for emergency department patients with acute migraine. Patients are only enrolled if they fail first line therapy with metoclopramide.

Full description

The investigators are testing the following hypothesis:

In a population of patients who present to an ED with acute migraine and have been treated with parenteral metoclopramide unsuccessfully, bilateral greater occipital nerve blocks with bupivicaine will provide greater rates of short-term and sustained headache freedom than bupivacaine injected intradermally.

Enrollment: 28 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• ED patient with acute migraine or probable migraine
• Fail first line therapy with metoclopramide

Exclusion criteria

• Can't obtain consent
• Concern for secondary headache
• Skull defect
• Propensity for bleeding
• Overlying infection
• Pregnancy
• Allergy, intolerance study medication

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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28 participants in 2 patient groups

Greater occipital nerve block

Experimental group

Description:

Bilateral greater occipital nerve block with 3cc of 0.5% bupivacaine, delivered using fan technique

Treatment:

Procedure: Greater occipital nerve block

Sham

Sham Comparator group

Description:

Bilateral intradermal injection of 0.5cc of 0.5% bupivacaine, delivered superficially to the area overlying the greater occipital nerve

Treatment:

Drug: Bupivacaine