We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Anatomical basis for simultaneous block of greater and third occipital nerves, with an ultrasound-guided technique.
- Authors
Kariya, Ken; Usui, Yosuke; Higashi, Naoko; Nakamoto, Tatsuo; Shimbori, Hironobu; Terada, Satoshi; Takahashi, Hideo; Ueta, Hisashi; Kitazawa, Yusuke; Sawanobori, Yasushi; Okuda, Yasuhisa; Matsuno, Kenjiro
- Abstract
Purpose: In some headache disorders, for which the greater occipital nerve block is partly effective, the third occipital nerve is also suggested to be involved. We aimed to establish a simple technique for simultaneously blocking the greater and third occipital nerves.Methods: We performed a detailed examination of dorsal neck anatomy in 33 formalin-fixed cadavers, and deduced two candidate target points for blocking both the greater and third occipital nerves. These target points were tested on three Thiel-fixed cadavers. We performed ultrasound-guided dye injections into these points, examined the results by dissection, and selected the most suitable injection point. Finally, this target point was tested in three healthy volunteers. We injected 4 ml of local anesthetic and 1 ml of radiopaque material at the selected point, guided with a standard ultrasound system. Then, the pattern of local anesthetic distribution was imaged with computed tomography.Results: We deduced that the most suitable injection point was the medial head of the semispinalis capitis muscle at the C1 level of the cervical vertebra. Both nerves entered this muscle, in close proximity, with little individual variation. In healthy volunteers, an anesthetic injected was confined to the muscle and induced anesthesia in the skin areas innervated by both nerves.Conclusions: The medial head of the semispinalis capitis muscle is a suitable landmark for blocking the greater and third occipital nerves simultaneously, by which occipital nerve involvement in various headache disorders may be rapidly examined and treated.
- Subjects
NERVE block; NECK anatomy; MEDICAL ultrasonics; HEADACHE treatment; ANATOMICAL injections; SPINAL nerves; COMPUTED tomography; ANATOMY
- Publication
Journal of Anesthesia, 2018, Vol 32, Issue 4, p483
- ISSN
0913-8668
- Publication type
Article
- DOI
10.1007/s00540-017-2429-9