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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
28
Bilateral greater occipital nerve block
0.5 cc of 0.5% bupivacaine injected intradermally
Montefiore Medical Center
The Bronx, New York, United States
Number of Participants Who Achieve Freedom From Headache
Pain assessed using a standard ordinal headache intensity scale, in which subjects describe their headache as "severe", "moderate", "mild", or "none". Those with headache level = none, experience freedom from headache.
Time frame: 30 minutes
Sustained Headache Relief
Attaining a headache level of "mild" or "none" within one hour of procedure and maintaining this for 48 hours without use of additional medication
Time frame: 48 hours
Would Want the Same Treatment Again During a Subsequent Migraine
Participants will be asked the following question: Do you want to receive the same procedure the next time you come to the ER with migraine?
Time frame: 48 hours
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