Use of this content is subject to the Terms and Conditions of the MD Consult web site.
Brown: Atlas of Regional Anesthesia, 3rd ed., Copyright © 2006 Saunders, An Imprint of Elsevier
< Previous Next >

PEARLS

To make the occipital block effective for pain diagnosis and therapy, the anesthesiologist must clarify the expectations regarding the block for the patient before performing it. Often patients reach the anesthesiologist only after a long and arduous trial of alternative pain therapies; thus, it is as important for the anesthesiologist to handle the psychosocial implications of the procedure as it is to discuss the technical features.

When a diagnostic block is planned, it is important to keep the dose of local anesthetic small to minimize confusion with relief of myofascial pain. Similarly, relief of ipsilateral retro-orbital or temporal pain after an occipital block does not rule out the possibility of occipital neuralgia as the cause of the pain syndrome, as pain relief is produced outside the typical sensory distribution of the occipital nerve. In some of these cases, owing to brain stem and spinal cord interneuronal connections between the trigeminal nucleus and the second cervical spinal nerve, retro-orbital pain is frequently relieved with a greater occipital nerve block.

< Previous Next >

About MD Consult Contact Us Terms and Conditions Privacy Policy Registered User Agreement
Copyright © 2007 Elsevier Inc. All rights reserved. www.mdconsult.com 
Bookmark URL: /das/book/0/view/1353/55.html/top