Pediatric Emergency Medicine, Montreal Children's Hospital - McGill University Health Center, 1001 Decarie Boulevard, Montreal, Quebec, H4A 3J1, Canada.
Curr Pain Headache Rep. 2017 Nov 9;21(12):50. doi: 10.1007/s11916-017-0650-8.
Peripheral nerve blocks of the scalp, mainly greater occipital nerve blocks, have received a renewed interest amongst pediatric providers as they offer an alternate option to provide both acute and chronic relief from the suffering of children with difficult to treat headaches. This narrative review will provide an in-depth discussion of the published pediatric-specific studies exploring the utility of nerve blocks for pediatric headache disorders.
A total of seven pediatric publications have been reported to date and reveal excellent therapeutic effectiveness of bilateral greater occipital nerve blocks on primary chronic headaches and post-traumatic headaches. Lidocaine is the preferred anesthetic choice and the value-added of concomitant steroids remains to be elucidated. It is important to ensure complete paresthesia of the blocked nerves to maximize effectiveness. The available studies suggest that peripheral nerve blocks of the scalp are an excellent tool that frontline clinicians can add to their armamentarium in treating pediatric headaches.
头皮外周神经阻滞，主要是枕大神经阻滞，在儿科医生中重新受到关注，因为它们为治疗难以治疗的头痛的儿童提供了一种替代方案，可以提供急性和慢性缓解。本综述将深入讨论已发表的专门针对儿科的研究，探讨神经阻滞在儿科头痛疾病中的应用。
迄今为止，已有 7 篇儿科文献报道，双侧枕大神经阻滞对原发性慢性头痛和创伤后头痛具有极好的治疗效果。利多卡因是首选的麻醉剂，皮质类固醇的附加价值仍有待阐明。重要的是要确保阻滞神经的完全感觉异常，以最大限度地提高疗效。现有研究表明，头皮外周神经阻滞是一种很好的工具，一线临床医生可以在治疗儿童头痛时将其添加到他们的治疗方法中。
