• Rev Bras Anestesiol · Sep 2016

    [Bilateral greater occipital nerve block for treatment of post-dural puncture headache after caesarean operations].

    • Esra Uyar Türkyilmaz, Eryilmaz Nuray Camgöz NC Zekai Tahir Burak Womens' Health Training and Research Hospital, Department of Anesthesiology and Reanimation, Ancara, Turquia., Güzey Nihan Aydin NA Zekai Tahir Burak Womens' Health Training and Research Hospital, Department of Anesthesiology and Reanimation, Ancara, Turquia., and Özlem Moraloğlu.
    • Zekai Tahir Burak Womens' Health Training and Research Hospital, Department of Anesthesiology and Reanimation, Ancara, Turquia. Electronic address: esrauyarturkyilmaz@yahoo.com.
    • Rev Bras Anestesiol. 2016 Sep 1; 66 (5): 445-50.

    BackgroundPost-dural puncture headache (PDPH) is an important complication of neuroaxial anesthesia and more frequently noted in pregnant women. The pain is described as severe, disturbing and its location is usually fronto-occipital. The conservative treatment of PDPH consists of bed rest, fluid theraphy, analgesics and caffeine. Epidural blood patch is gold standard theraphy but it is an invasive method. The greater occipital nerve (GON) is formed of sensory fibers that originate in the C2 and C3 segments of the spinal cord and it is the main sensory nerve of the occipital region. GON blockage has been used for the treatment of many kinds of headache. The aim of this retrospective study is to present the results of PDPH treated with GON block over 1 year period in our institute.Methods16 patients who had been diagnosed to have PDPH, and performed GON block after caesarean operations were included in the study. GON blocks were performed as the first treatment directly after diagnose of the PDPH with levobupivacaine and dexamethasone.ResultsThe mean VAS score of the patients was 8.75 (±0.93) before the block; 3.87 (±1.78) 10min after the block; 1.18 (±2.04) 2h after the block and 2.13 (±1.64) 24h after the block. No adverse effects were observed.ConclusionsTreatment of PDPH with GON block seems to be a minimal invasive, easy and effective method especially after caesarean operations. A GON block may be considered before the application of a blood patch.Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

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