Greater Occipital Nerve Block With Bupivacaine for Acute Migraine
Purpose
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.
Condition
- Migraine
Eligibility
- Eligible Ages
- Over 18 Years
- Eligible Genders
- All
- Accepts Healthy Volunteers
- No
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
Study Design
- Phase
- Phase 3
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel Assignment
- Primary Purpose
- Treatment
- Masking
- Double (Participant, Outcomes Assessor)
Arm Groups
| Arm | Description | Assigned Intervention |
|---|---|---|
|
Experimental Greater occipital nerve block |
Bilateral greater occipital nerve block with 3cc of 0.5% bupivacaine, delivered using fan technique |
|
|
Sham Comparator Sham |
Bilateral intradermal injection of 0.5cc of 0.5% bupivacaine, delivered superficially to the area overlying the greater occipital nerve |
|
More Details
- Status
- Completed
- Sponsor
- Montefiore Medical Center
Study Contact
Detailed 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.