The Role of Other Peripheral Nerve Blocks
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Nerve blocks are therapeutic options in patients with head and neck neuralgias and can also be effective in primary headache disorders. Nerve blocks are considered for patients with various disorders including patients in the period between onabotulinum toxin A injections or those avoiding drug use. Their combinations can be used in patients with headache disorders. Nerve blocks for headaches generally consist of small subcutaneous injections of amide-type local anesthetics such as lidocaine and bupivicaine.
The practical application and efficacy of sphenopalatine ganglion blocks; supratrochlear, auriculotemporal, supraorbital, infraorbital, and mental nerve blocks; and cervical root blocks are briefly discussed in this chapter.
KeywordsHeadache Treatment Local anesthetics Nerve block Efficacy
Supraorbital and supratrochlear nerve block. Supratrochlear nerve is blocked by inserting needle above the eyebrow over its medial border. Supraorbital nerve runs approximately 2 cm lateral to the supratrochlear nerve (MOV 109931 kb)
Infraorbital nerve block. Aplication is done lateral from the 3rd canine teeth (MOV 38043 kb)
Sphenopalatin ganglion blockage (SPG)- Procedure A. Intranasal application using a cotton swab applicator. Patient lies in a supine position and medication given via nares with cotton applicator soaked in an anesthetic solution. The applicator is placed approximately 6 cm into each nares deep to the post middle tirbunate where SPG located for 10 minutes (MOV 44574 kb)
Sphenopalatin ganglion blockage (SPG) Procedure B. Allevio device has a angled flexible sheath and directional arrow. The patient lies in a supine position and chin toward the ceiling. The device is inserted along the anterior nasal passage about 6–7 cm until the bone felt and placed to the middle nasal tirbunate. It delivers anesthetic solution to the SPG (MOV 48001 kb)
Sphenopalatin ganglion blockage (SPG) Procedure C. The technique using nasal endoscope which is a good tool to visualise the foramen for an effective block. The patient assumes a supine posture on the seat with the head slightly elevated. The target is the posteriosuperior aspect of the middle turbinate just next to the ethmoid crest. The gauze soaked into anesthetic solution is inserted just on the SPG covered with nasal mucosa and wait for 10 minutes that local anesthetic diffuse across this layer into ganglion (MOV 46274 kb)
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