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Aesthet Surg J 2020 Jan 30. Epub 2020 Jan 30.

Background: Microfocused ultrasound with visualization has become one of the more popular nonsurgical facial rejuvenation therapies available. Although the treatment has gained wide acceptance, providing adequate pain relief during the procedure may be challenging.

Objectives: We hypothesized that nerve blocks prior to treatment would be well-tolerated and significantly reduce patient discomfort. Read More

Medicine (Baltimore) 2019 Aug;98(31):e16484

Introduction: Paroxysmal hemicrania (PH) is a chronic headache disorder characterized by unilateral pain attacks accompanied by cranial autonomic symptoms and responds to indomethacin completely. There are few alternative treatment options for the patients who cannot tolerate indomethacin. Studies exploring the effects of repetitive peripheral cranial nerve blocks in the management of chronic PH are limited. Read More

BMC Neurol 2019 Jun 22;19(1):136. Epub 2019 Jun 22.

Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University Rof Rome Polo Pontino, Latina, Italy.

Background: A short ketogenic diet (KD) treatment can prevent migraine attacks and correct excessive cortical response. Here, we aim to prove if the KD-related changes of cortical excitability are primarily due to cerebral cortex activity or are modulated by the brainstem.

Methods: Through the stimulation of the right supraorbital division of the trigeminal nerve, we concurrently interictally recorded the nociceptive blink reflex (nBR) and the pain-related evoked potentials (PREP) in 18 migraineurs patients without aura before and after 1-month on KD, while in metabolic ketosis. Read More

J Vet Dent 2019 Mar;36(1):40-45

1 Rood and Riddle Equine Hospital, Lexington, KY, USA.

Regional anesthesia of the equine head is commonly performed to allow oral extraction of diseased teeth in the standing horse. The use of 4 blocks (infraorbital nerve, maxillary nerve, mental nerve, and mandibular nerve) is well documented for desensitization of dental quadrants for oral surgery for exodontia, but descriptions of associated complications are limited. A total of 270 regional nerve blocks were performed on 162 equine patients in a second opinion referral hospital setting. Read More

Cephalalgia 2019 Oct 13;39(12):1488-1499. Epub 2019 May 13.

Headache Group, Institute of Neurology and The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.

Background: Multiple cranial nerve blocks of the greater and lesser occipital, supraorbital, supratrochlear and auriculotemporal nerves are widely used in the treatment of primary headaches. We present efficacy and safety data for these procedures.

Methods: In an uncontrolled open-label prospective study, 119 patients with chronic cluster headache, chronic migraine, short lasting unilateral neuralgiform attack disorders, new daily persistent headaches, hemicrania continua and chronic paroxysmal hemicrania were examined. Read More

Clin Med Insights Ear Nose Throat 2019 15;12:1179550619834949. Epub 2019 Mar 15.

Department of Otorhinolaryngology - Head and Neck Surgery, Center for Facial Plastic and Reconstructive Surgery, Diakonessen Hospital, Utrecht, The Netherlands.

Entrapment neuropathy is a known cause of neurological disorders. In the head and neck area, this pathophysiological mechanism could be a trigger for headache. Over the last few decades, injection of botulinum toxin type A in the muscles that are causing the compression as well as surgical decompression have proved to be effective treatment methods worldwide for large numbers of patients with daily headaches. Read More

Curr Med Res Opin 2019 05 31;35(5):909-915. Epub 2018 Oct 31.

c Department of Neurology , Gaziosmanpaşa Taksim Training and Research Hospital , Istanbul , Turkey.

Objective: Nerve injections have been used for the acute and preventive treatment of migraine in recent decades. Most of these injections focused on greater occipital nerve (GON) blockade. However, few studies were placebo controlled, and only a few of them investigated GON and supraorbital nerve (SON) blockade together. Read More

J Pain Res 2018 8;11:1497-1501. Epub 2018 Aug 8.

Department of Anesthesiology and Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, People's Republic of China,

Pulsed radiofrequency is an effective, safe, and nondestructive pain treatment technique that has been insufficiently reported in the treatment of supraorbital neuralgia. We report the successful use of pulsed radiofrequency to alleviate acute severe supraorbital neuralgia in a post-craniotomy patient. A 52-year-old female, who had acute severe supraorbital neuralgia after having received a right frontal craniotomy and with poor efficacy in response to medication and a nerve block, was subjected to ultrasound-guided pulsed radiofrequency treatment and experienced complete pain relief, as a result of which the patient stopped taking all analgesic drugs. Read More

Am J Emerg Med 2018 11 8;36(11):2058-2060. Epub 2018 Aug 8.

Department of Anesthesiology, New York-Presbyterian Hospital/Weill Cornell Medicine, 525 East 68th Street, Box 124, New York, NY 10065, United States of America.

Objective: After medication failure, patients with refractory trigeminal neuralgia (TGN) often present urgently and seek more potent or invasive therapies such as opioids or surgical options. Peripheral nerve blocks, safe and simple, may offer extended pain relief prior to opioid use or more invasive ganglion level procedures.

Methods: We report a retrospective case-series (urgent care, at a large urban medical center, over a 2 year period) of nine patients with intractable primary TGN who underwent peripheral trigeminal nerve blocks after failing conservative medical therapy. Read More

Can Vet J 2018 07;59(7):763-769

Elders Equine Veterinary Service, Box 66047, 3665 Portage Avenue, Winnipeg, Manitoba (Bell, Torske); Royal University Hospital, University of Saskatchewan, Saskatoon, Saskatchewan (Hnenny).

A 5-year-old Hannovarian warmblood gelding was presented for recurrent headshaking exacerbated with exercise. The horse displayed clinical signs of repetitive vertical head movements, face rubbing on the forelimbs and on the ground, repetitive sneezing, and striking the muzzle with his forelimbs. The clinical signs resulted in a horse that could not be ridden and was dangerous. Read More

Pain Res Manag 2018 2;2018:5480728. Epub 2018 Apr 2.

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Bei-Hu Branch, Taipei, Taiwan.

Orofacial myofascial pain is prevalent and most often results from entrapment of branches of the trigeminal nerves. It is challenging to inject branches of the trigeminal nerve, a large portion of which are shielded by the facial bones. Bony landmarks of the cranium serve as important guides for palpation-guided injections and can be delineated using ultrasound. Read More

Anat Cell Biol 2018 Mar 28;51(1):19-24. Epub 2018 Mar 28.

Department of Basic Sciences, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka.

Significant variations exist in the occurrence, form, and position of supraorbital nerve exits through the frontal bone. Detailed knowledge of the positional variations of supraorbital exits is important to ensure safe and successful regional anesthesia, and to avoid iatrogenic nerve injuries during surgery of the orbitofacial region. Supraorbital nerve exits from 116 sides of 58 dry intact adult skulls (37 male and 21 female) in a Sri Lankan population were examined to determine the morphological features and the precise position in relation to the facial midline, temporal crest of frontal bone, and frontozygomatic suture. Read More

Agri 2018 Jan;30(1):28-30

Department of Neurology, Training and Research Hospital, Istanbul, Turkey.

Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a rare, primary headache syndrome, which is classified as a subtype of trigeminal autonomic cephalalgias. Although SUNCT is usually refractory to treatment, several antiepileptic drugs have recently shown promising results for its treatment. However, there is a lack of evidence regarding the course of SUNCT during pregnancy and the available treatment options. Read More

Dermatol Surg 2018 May;44(5):760-761

Plastic & Hair Restorative Surgery, Hair Transplant Institute, Islamabad, Pakistan.

Headache 2017 Oct 18;57(9):1433-1442. Epub 2017 Aug 18.

Headache Unit, Department of Neurology, Hospital Clínico San Carlos, Madrid, Spain.

Objective: The aim of this study was to describe clinical features unique to supratrochlear neuralgia.

Background: The supratrochlear nerve supplies the medial aspect of the forehead. Due to the intricate relationship between supraorbital and supratrochlear nerves, neuralgic pain in this region has been traditionally attributed to supraorbital neuralgia. Read More

Headache 2016 Nov 12;56(10):1597-1607. Epub 2016 Oct 12.

Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, OH, USA.

Objective: To describe current patterns of use of nerve blocks and trigger point injections for treatment of pediatric headache.

Background: Peripheral nerve blocks are often used to treat headaches in adults and children, but the available studies and practice data from adult headache specialists have shown wide variability in diagnostic indications, sites injected, and medication(s) used. The purpose of this study was to describe current practice patterns in the use of nerve blocks and trigger point injections for pediatric headache disorders. Read More

Neurologia 2018 Apr 25;33(3):160-164. Epub 2016 Jul 25.

Unidad de Cefalea, Servicio de Neurología, Hospital Universitari Vall d'Hebron, Grupo de Investigación en Cefalea, VHIR, UAB, Barcelona, España.

Anaesthetic blocks, whether used alone or combined with other treatments, are a therapeutic resource for many patients with headaches. However, usage patterns by different professionals show significant heterogeneity.

Material And Methods: The Headache Study Group of the Spanish Society of Neurology (GECSEN) designed a self-administered cross-sectional survey and sent it to all group members through the SEN's scientific area web platform in February 2016. Read More

Dermatol Surg 2016 Aug;42(8):992-8

*Department of Anatomy, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea; †Department of Ophthalmology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.

Background: Blocking the supraorbital nerve (SON) and supratrochlear nerve (STN) by injecting anesthetic distal to the surgical site has the advantage in upper eyelid surgery that avoids obscuring the surgical landmarks and compromising the levator function.

Objective: To identify the emerging points of the SON and STN in the supraorbital margin with reference to the lacrimal caruncle.

Methods: Forty-nine orbits from 27 embalmed Korean cadavers were dissected. Read More

Cephalalgia 2017 Aug 12;37(9):864-872. Epub 2016 Jun 12.

4 Department of Preventive Medicine, Instituto de Investigación Sanitaria San Carlos, Hospital Clínico San Carlos, Madrid, Spain.

Background Greater occipital nerve (GON) blocks are widely used for the treatment of headaches, but quality evidence regarding their efficacy is scarce. Objective The objective of this article is to assess the short-term clinical efficacy of GON anaesthetic blocks in chronic migraine (CM) and to analyse their effect on pressure pain thresholds (PPTs) in different territories. Participants and methods The study was designed as a double-blind, randomised, placebo-controlled clinical trial. Read More

Vet Surg 2016 May 4;45(4):494-8. Epub 2016 Apr 4.

College of Veterinary Medicine, Lincoln Memorial University, Harrogate, Tennessee.

Objective: To describe the anatomical location of the ethmoidal nerve in the equine periorbital region and to determine the accuracy of a technique used to deposit local anesthetic solution adjacent to the nerve.

Study Design: Prospective experimental study.

Animals: Adult equine cadaver heads (n=6 for preliminary dissection; n=15 [30 nerve sites] for evaluation of injection technique). Read More

Arch Craniofac Surg 2016 Mar 21;17(1):9-13. Epub 2016 Mar 21.

Department of Plastic and Reconstructive Surgery, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.

Background: Position of the facial foramina is important for regional block and for various maxillofacial surgical procedures. In this study, we report on anthropometry and morphology of these foramina using three-dimensional computed tomography (3D-CT) data.

Methods: A retrospective review was performed for all patients who have undergone 3D-CT scan of the facial skeleton for reasons other than fracture or deformity of the facial skeleton. Read More

JA Clin Rep 2016 5;2(1):43. Epub 2016 Dec 5.

Department of Anesthesiology and Intensive Care Medicine, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi 783-8505 Japan.

Background: Post-herpetic itch (PHI) is a neuropathic itch syndrome following herpes zoster. It has been reported that PHI is occasionally sufficiently severe to compromise patients' quality of life and frequently refractory to treatment. Here, we present a case of severe chronic PHI successfully treated with supraorbital nerve block using a high concentration of tetracaine dissolved in bupivacaine. Read More

Neurologia 2016 Sep 24;31(7):445-51. Epub 2014 Dec 24.

Servicio de Neurología, Hospital Clínico Universitario de Valladolid, Valladolid, España. Electronic address:

Introduction: Anaesthetic blockade of pericranial nerves is frequently used to treat headache disorders. There is no evidence on indication of this treatment for migraine. We aim to evaluate its effectiveness as a preventive treatment for migraine using specific indication criteria. Read More

J Neurosurg Anesthesiol 2016 Jan;28(1):1-5

*Department of Anesthesiology, Sapporo Medical University School of Medicine, Sapporo‡Department of Clinical Pharmaceutics, Hokkaido Pharmaceutical University School of Pharmacy, Otaru, Hokkaido, Japan†Department of Anesthesiology, Penn State Hershey Medical Center, Hershey, PA.

Background: Mixtures of various local anesthetics, such as lidocaine and ropivacaine, have been widely used. However, their efficacy and safety for scalp nerve blocks and local infiltration during awake craniotomy have not been fully elucidated.

Methods: We prospectively investigated 53 patients who underwent awake craniotomy. Read More

Obstet Gynecol 2014 Dec;124(6):1169-74

Department of Obstetrics and Gynecology & Women's Health, Montefiore Medical Center, and the Department of Neurology, Montefiore Headache Center, Albert Einstein College of Medicine, Bronx, New York.

Objective: To describe the use of peripheral nerve blocks in a case series of pregnant women with migraine.

Methods: A retrospective chart review of all pregnant patients treated with peripheral nerve blocks for migraine over a 5-year period was performed. Injections targeted greater occipital, auriculotemporal, supraorbital, and supratrochlear nerves using local anesthetics. Read More

Am Fam Physician 2014 Jun;89(12):956-62

Headquarters Air Armament Center Family Medicine Residency, Eglin Air Force Base, FL, USA.

When choosing an infiltrative anesthetic agent, the type of procedure, the length of time required for anesthesia, and the pharmacodynamics of each medication are important considerations. Distraction techniques and buffering with sodium bicarbonate can be used to decrease the pain associated with injection. Local cutaneous infiltration is the most commonly used anesthetic technique and involves direct injection into the area requiring anesthesia. Read More

PLoS One 2014 17;9(6):e100198. Epub 2014 Jun 17.

Headache Research Unit, University Department of Neurology, Liège University, Liège, Belgium.

Bright light can cause excessive visual discomfort, referred to as photophobia. The precise mechanisms linking luminance to the trigeminal nociceptive system supposed to mediate this discomfort are not known. To address this issue in healthy human subjects we modulated differentially visual cortex activity by repetitive transcranial magnetic stimulation (rTMS) or flash light stimulation, and studied the effect on supraorbital pain thresholds and the nociceptive-specific blink reflex (nBR). Read More

Morphologie 2014 Dec 20;98(323):166-70. Epub 2014 May 20.

Department of Anatomy, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan 342005, India.

Purpose: Various studies have been conducted on morphometric variations of infraorbital foramen to provide data to surgeons for nerve block in infraorbital region. This study aims to analyse the anatomical variations by comparing various morphometric measurements of infraorbital foramen in dry skulls of adult North Indian population. This study becomes relevant in the present study group as very scant data is available about the variations and morphometric measurements in Indian population. Read More

Curr Neurol Neurosci Rep 2014 Jul;14(7):459

Department of Neurology, University of Kentucky, 740 S. Limestone, L445, Lexington, KY, 40536, USA.

The neuralgias are characterized by pain in the distribution of a cranial or cervical nerve. While most often brief, severe, and paroxysmal, continuous neuropathic pain may occur. The most commonly encountered entities include trigeminal, postherpetic, glossopharyngeal, and occipital neuralgia. Read More

Eur J Neurosci 2014 Feb;39(3):501-7

Don Carlo Gnocchi Onlus Foundation, Via Maresciallo Caviglia, 30-00135, Rome, Italy.

Monoamines have an important role in neural plasticity, a key factor in cortical pain processing that promotes changes in neuronal network connectivity. Monoamine oxidase type A (MAOA) is an enzyme that, due to its modulating role in monoaminergic activity, could play a role in cortical pain processing. The X-linked MAOA gene is characterized by an allelic variant of length, the MAOA upstream Variable Number Tandem Repeat (MAOA-uVNTR) region polymorphism. Read More

Eur Rev Med Pharmacol Sci 2013 Jul;17(13):1778-81

Department of Neurology, Corlu State Hospital, Tekirdag, Turkey.

Background: Nerve blockades are used for the treatment of acute migraine episodes in emergency room conditions and beneficial results are obtained from this clinical use. Although this is the case, there are limited numbers of studies investigating the long-term effects of such an approach.

Patients And Methods: In this investigation, we had 26 patients diagnosed as migraine based on the ICHD II criteria, these were injected with 1% lidocaine at supraorbital and infraorbital nerve localizations and clinical results were evaluated after 6 months of follow-up. Read More

Middle East J Anaesthesiol 2013 Feb;22(1):79-85

Mount Sinai School of Medicine.

Background: Patients undergoing stereotactic headframe placement for radiosurgery report that discomfort associated with the headframe often lasts for the duration of the treatment day (approximately 6 hours). We hypothesize that blockade of scalp nerves prior to headframe placement reduces the incidence of moderate to severe head pain during the entire treatment day. We describe a randomized, double-blind, placebo-controlled study of awake patients having radiosurgery for intracranial pathology that examines whether scalp nerve blockade and local anesthetic infiltration results in superior patient comfort versus infiltration alone. Read More

Cephalalgia 2013 Oct 14;33(14):1198-202. Epub 2013 May 14.

Neurology Department of Fundación Alcorcón University Hospital, Alcorcón, Spain.

Background: The lacrimal nerve supplies the lacrimal gland, the lateral upper eyelid, and a small cutaneous area adjacent to the external CANTHUS . First division trigeminal neuralgia, supraorbital/supratrochlear neuralgia, and infraorbital neuralgia have been acknowledged as neuralgic causes of pain in the forehead and periorbit. However, the lacrimal nerve has never been identified as a source of facial pain. Read More

Headache 2013 Mar 13;53(3):437-46. Epub 2013 Feb 13.

The Headache Center of Southern California - Neurology, Encinitas, CA, USA.

Objective: To describe a standardized methodology for the performance of peripheral nerve blocks (PNBs) in the treatment of headache disorders.

Background: PNBs have long been employed in the management of headache disorders, but a wide variety of techniques are utilized in literature reports and clinical practice.

Methods: The American Headache Society Special Interest Section for PNBs and other Interventional Procedures convened meetings during 2010-2011 featuring formal discussions and agreements about the procedural details for occipital and trigeminal PNBs. Read More

Pain Med 2012 Nov 8;13(11):1469-73. Epub 2012 Oct 8.

The Mount Sinai School of Medicine, Department of Rehabilitation Medicine, One Gustave Levy Place, Box 1240, New York, NY 10029-6574, USA.

Objective: To describe a technique for and assess accuracy of ultrasound-guided supraorbital, infraorbital, and mental nerve injections in a cadaveric model. Prior studies have shown that peripheral trigeminal nerve injections can be beneficial for a subgroup of patients for whom surgical treatment is not appropriate. Accurate injection is necessary to limit side effects and improve its efficacy. Read More

J Craniofac Surg 2012 Sep;23(5):1457-9

Norman Bethune Medical School of Jilin University, Changchun, Jilin Province, People's Republic of China.

The study aimed to provide the anatomic data for puncture of foramen ovale cranium in oral cavity. We scan 100 volunteers' skull on computed tomography who have no lesion of skull base, of which the images were for three-dimensional reconstruction. The following observations and measurements were carried out: the shape, size of foramen ovale cranium, and the angle and length of puncture line. Read More

Rev Neurol 2012 Sep;55(5):270-8

Servicio de Neurología. Hospital Clínico Universitario de Valladolid, Valladolid, España.

Introduction: Hemicrania continua is characterised by a continuous unilateral pain, which frequently gets worse in association with autonomic symptoms. It is probably little known and underdiagnosed. Its diagnosis requires a response to indomethacin, which is not always well tolerated. Read More

J Pain 2012 Sep 14;13(9):866-73. Epub 2012 Aug 14.

Don Carlo Gnocchi Onlus Foundation, Milan, Italy.

Unlabelled: Cortical pain processing is associated with large-scale changes in neuronal connectivity, resulting from neural plasticity phenomena of which brain-derived neurotrophic factor (BDNF) is a central driver. The common single nucleotide polymorphism Val66Met is associated with reduced BDNF activity. Using the trigeminal pain-related evoked potential (tPREP) to repeated electrical painful stimuli, we investigated whether the methionine substitution at codon 66 of the BDNF gene was associated with changes in cortical processing of noxious stimuli. Read More

Anat Rec (Hoboken) 2012 Sep 16;295(9):1494-503. Epub 2012 Jul 16.

Department of Anthropology, Wroclaw University, Wroclaw, Poland.

The aim of this study was to provide the morphological and morphometric data of the supraorbital foramina or notches related to sex, side, and the climatic conditions where the population lived. It was hypothesized that the distribution of the occurrence and location of these openings depends on climatic conditions in which the population lived. Orbits from 866 dried skulls obtained from three climatic regions: warm, temperate, and cold were examined. Read More

Cephalalgia 2012 Apr 21;32(6):505-8. Epub 2012 Mar 21.

Neurology Department, Hospital Clínico Universitario, Valladolid, Spain.

Objectives: A complete response to indomethacin is required for the diagnosis of hemicrania continua (HC). Nevertheless, patients may develop side effects leading to withdrawal of this drug. Several alternatives have been proposed with no consistent effectiveness. Read More

Ann Ital Chir 2012 Jan-Feb;83(1):79-80

J Eur Acad Dermatol Venereol 2012 Aug 13;26(8):1035-7. Epub 2011 Sep 13.

Department of Dermatology and Venereology, Institute of Clinical Sciences at Sahlgrenska Academy, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden.

Background: Peripheral nerve blocks in the head and neck region can be useful for a large number of surgical or otherwise painful procedures carried out by dermatologists. As anaesthesiologists cannot always be available to help dermatologists place nerve blocks in outpatient settings, training courses for these physicians are warranted.

Objectives: To present a method of teaching nerve blocks for the face and scalp to dermatologists during residency and/or continuing medical education programmes. Read More

Agri 2011 Apr;23(2):84-7

Department of Anaesthesiology and Reanimation, Başkent University, Turkey.

Acute herpes zoster (AHZ) causes postherpetic neuralgia (PHN) in 48-75% of patients. Nerve blocks performed in the acute phase of HZ may treat the pain and prevent PHN development. Here, we present pain relief with modified van-Lint block in two cases with AHZ involving vesicles on the traces of the supraorbital and supratrochlear nerves. Read More

Anesth Analg 2011 Jan 16;112(1):224-7. Epub 2010 Nov 16.

Department of Anesthesiology, Advocate Illinois Masonic Medical Center, 836 West Wellington Avenue, Suite 4815, Chicago, IL 60657, USA.

We describe the case of a 17-year-old boy with dermatologic herpes simplex virus-1 outbreaks with incapacitating facial pain requiring multiple hospitalizations. He failed to respond to aggressive treatments including antiviral drugs, opioid analgesics, stellate ganglion, and supraorbital and supratrochlear nerve blocks. The patient elected to undergo dexamethasone and lidocaine Gasserian ganglion block under computed tomography-scan guidance. Read More

Headache 2010 Jun 7;50(6):943-52. Epub 2010 May 7.

Neurologic Group of Bucks/Montgomery County, Doylestown, PA, USA.

Interventional procedures such as peripheral nerve blocks (PNBs) and trigger point injections (TPIs) have long been used in the treatment of various headache disorders. There are, however, little data on their efficacy for the treatment of specific headache syndromes. Moreover, there is no widely accepted agreement among headache specialists as to the optimal technique of injection, type, and doses of the local anesthetics used, and injection regimens. Read More

Neurotherapeutics 2010 Apr;7(2):197-203

Department of Neurology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire 03756, USA.

Nerve blocks and neurostimulation are reasonable therapeutic options in patients with head and neck neuralgias. In addition, these peripheral nerve procedures can also be effective in primary headache disorders, such as migraine and cluster headaches. Nerve blocks for headaches are generally accomplished by using small subcutaneous injections of amide-type local anesthetics, such as lidocaine and bupivicaine. Read More

Anaesthesist 2009 Sep;58(9):949-58; quiz 959-60

Klinik für Anästhesiologie, Universitätsklinikum Regensburg, 93042, Regensburg, Deutschland.

Safe and effective cranial analgesia can be achieved by blocking the sensitive nerves of that region. These include the supraorbital nerve, the supratrochlear nerve, the zygomaticotemporal nerve, the auriculotemporal nerve and the greater and lesser occipital nerves which are accessible at typical and most proximal points. Preferably long acting local anesthetics such as ropivacaine 0. Read More

Br J Dermatol 2009 Aug 30;161(2):353-6. Epub 2009 Apr 30.

Department of Dermatology, Instituto Valenciano de Oncología, Valencia 46009, Spain.

Background: Photodynamic therapy (PDT) is an effective treatment for actinic keratoses, Bowen's disease and basal cell carcinoma. The main drawback of PDT is pain during application.

Objectives: To compare the efficacy of supratrochlear and supraorbital nerve block with cold air analgesia to control the pain experienced during PDT. Read More

Eur J Anaesthesiol 2009 Apr;26(4):298-303

Karadeniz Technical University, Medical Faculty, Farabi Hospital, Department of Anesthesiology, Trabzon, Turkey.

Background And Objective: The insertion of skull pins into the periosteum induces not only a haemodynamic response but also an increase in stress hormones. We compared the effects of scalp-nerve block, infiltration anaesthesia, and routine anaesthesia during skull-pin insertion on haemodynamic and stress responses to craniotomy.

Methods: Forty-five ASA I or II patients, scheduled for elective craniotomies, were enrolled in this prospective, randomized, placebo-controlled study. Read More