36498 Four specific blocks for headache relief: investigating potential shared mechanisms

• Published in: Regional anesthesia and pain medicine Vol. 48; no. Suppl 1; p. A209
• Main Author: Mavropoulos, Christos
• Format: Journal Article
• Language: English
• Published: Secaucus BMJ Publishing Group Ltd 01.09.2023; BMJ Publishing Group LTD
• Subjects: Central nerve blocks; Erector spine plane block; greater occipital nerve block; Headache; Headaches; Local anesthesia; migraine; post dural puncture headache; sphenopalatine ganglion block; Spine; stellate ganglion block
• ISSN: 1098-7339; 1532-8651
• DOI: 10.1136/rapm-2023-ESRA.383

Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page)Background and AimsThe impact of four distinct blocks, namely erector spine plane block , stellate ganglion block, sphenopalatine ganglion block and greater occipital nerve block, on headache relief as a symptomatic manifestation has been observed. Existing literature has documented a reduction in the intensity, duration, and frequency of pain, along with enhanced patient satisfaction, in primary headaches. As a result, the possibility of a shared mechanism of action warrants investigationMethodsA comprehensive search of the PubMed electronic database was conducted to identify relevant case reports, retrospective studies and case series encompassing the four blocks and diverse headache conditions. The utilized keywords included sphenopalatine ganglion block, greater occipital nerve block, erector spinae plane block, stellate ganglion block, post-dural puncture headache, tension headache, migraine, and cluster headacheResultsThe findings indicate that all four blocks have demonstrated effective alleviation of headache symptoms in a majority of primary and secondary headache cases.ConclusionsProposed mechanisms encompass interactions with the trigemino-cervical complex, modulation of cerebral circulation and autonomic outflow. Further exploration of the common pathophysiological mechanisms underlying headaches and the identification of suitable therapeutic targets should be pursued