Occipital nerve block for the short-term preventive treatment of XXXX : A randomized, double-blinded, placebo-controlled study.

@entity1 @entity1667 @entity1425 @entity2704 @entity1341 @entity3303 @entity10 @entity288
BACKGROUND: Occipital nerve (ON) injections with @entity288 and/or local anesthetics have been employed for the acute and preventive treatment of @entity2704 for decades. However, to date there is no randomized, placebo-controlled evidence to support the use of occipital nerve block (ONB) for the prevention of @entity2704 . OBJECTIVE: The objective of this article is to determine the efficacy of ONB with local anesthetic and corticosteroid for the preventive treatment of @entity2704 . @entity1 AND METHODS: @entity1 between 18 and 75 years old with ICHD-II-defined episodic (> 1 attack per week) or chronic @entity2704 (modified ICHD-II as @entity1 with   >   10 days with consumption of acute medications were permitted into the study) were randomized to receive either 2.5   ml 0.5% @entity1341 plus 0.5   ml (20   mg) @entity1667 over the ipsilateral ( @entity10 ) or bilateral ( @entity10 ) ON or 2.75   ml normal saline plus 0.25   ml 1% @entity3303 without @entity1425 (placebo). @entity1 completed a one-month @entity10 diary prior to and after the double-blind injection. The primary outcome measure was defined as a 50% or greater reduction in the frequency of days with moderate or severe @entity2704 @entity10 in the four-week post-injection compared to the four-week pre-injection baseline period. RESULTS: Thirty-four @entity1 received active and 35 @entity1 received placebo treatment. Because of missing data, the full analysis of 33 @entity1 in the active and 30 @entity1 in the placebo group was analyzed for efficacy. In the active and placebo groups respectively, the mean frequency of at least moderate (mean 9.8 versus 9.5) and severe (3.6 versus 4.3) @entity2704 days and acute medication days (7.9 versus 10.0) were not substantially different at baseline. The percentage of @entity1 with at least a 50% reduction in the frequency of moderate or severe @entity10 days was 30% for both groups (10/30 vs nine of 30,    0.00, 95% CI -0.22 to 0.23). CONCLUSIONS: Greater ONB does not reduce the frequency of moderate to severe @entity2704 days in @entity1 with episodic or chronic @entity2704 compared to placebo. The study was registered with ClinicalTrial.gov (NCT00915473).
