Efficacy of Ultrasound-Guided Multifidus Cervicis Plan Block Vs Greater Occipital Nerve Block for Cervicogenic Headache
Efficacy of Ultrasound-Guided Multifidus Cervicis Plan Block Vs Greater Occipital Nerve Block for Cervicogenic Headache
Background: Cervicogenic headache (CH) described as a chronic hemi-cranial pain resulted from
 a disorder of the cervical spine and its anatomic structures innervated by the C1, C2, and C3
 cervical spinal nerves. Traditionally noninvasive and invasive techniques were used for
 treatment. Greater occipital nerve block is the most frequent peripheral nerve block invasive
 technique used for the management of cervicogenic headache Objectives: The study was done to
 compare the efficacy of two different techniques: multifidus cervicus plan block and greater
 occipital nerve block in treatment of refractory cervicogenic headache using ultrasound
 guided.

 Patients and Methods: sixty patients with cervicogenic headache were recruited and diagnosed
 according to ICHD-ш Beta version. Divided into two group, one for greater occipital nerve
 block and the other for multifidus cervicis plane block with ultrasound guided.
This study was done to compare the efficacy of two different techniques: multifidus cervicus
 plane block and greater occipital nerve block in treatment of cervicogenic headache using
 ultrasound guided.

 This prospective study that was approved by Institutional Review Board (IRB), Mansoura
 Faculty of Medicine, Mansoura University, Cairo Egypt (Code Number: R/19.04.483) and all
 participants gave written informed consent. The procedures followed were in accordance with
 our protocol.

 This study included patients with cervicogenic headache disorders that diagnosed according to
 International Classification of Headache Disorder version III (ICHD-III beta version)
 criteria (18)

 Full clinical neurological examination was done for all patients. Blood samples for routine
 laboratory investigations (Complete blood count, creatinine, liver function tests, PT, APTT)
 were taken from all patients, electrocardiography (ECG) were done for all patients. Pain
 intensity was evaluated via visual analog scale (VAS) scores (0 -10). Pain intensity
 evaluation will be done at initial presentation then after 2 and 4 weeks, using the VAS scale
 for affected side of cervicogenic headache. Saturation of pulse oxygen (SpO2), all Procedures
 performed using ultrasound system with a 7 - 13 MHz multi-frequency transducer (LOGIQ P5; GE
 Healthcare).
Inclusion Criteria:

 History of occipital nerve injection, occipital nerve stimulation or history of surgical
 procedures in the occipital region,

 Exclusion Criteria:

 -  History of allergic reaction to the substance to be applied as local anesthetic.,

 -  Pregnancy or lactation,

 -  Uncontrolled hypertension,

 -  Uncontrolled diabetes mellitus,

 -  Uncompensated congestive heart failure,

 -  Chronic renal failure,

 -  Chronic liver disease,

 -  Tumor and/or vascular disease,

 -  Inflammatory and/or infectious diseases,

 -  Anticoagulant or antiplatelet medication use that may interfere with the injection
 process were also excluded.