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Greater Occipital Nerve Block With Bupivacaine for Acute Migraine

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT02665273
Recruitment Status : Completed
First Posted : January 27, 2016
Last Update Posted : August 31, 2018
Information provided by (Responsible Party):
Benjamin W. Friedman, MD, Montefiore Medical Center

Brief Summary:
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.

Condition or disease Intervention/treatment Phase
Migraine Procedure: Greater occipital nerve block Drug: Bupivacaine Phase 2

Detailed Description:

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.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 78 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Randomized, Sham-controlled Trial of Greater Occipital Nerve Block as Second Line Therapy for ED Patients With Acute Migraine
Actual Study Start Date : July 1, 2015
Actual Primary Completion Date : January 2018
Actual Study Completion Date : January 2018

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Headache Migraine

Arm Intervention/treatment
Experimental: Greater occipital nerve block
Bilateral greater occipital nerve block with 3cc of 0.5% bupivacaine, delivered using fan technique
Procedure: Greater occipital nerve block
Bilateral greater occipital nerve block

Sham Comparator: Sham
Bilateral intradermal injection of 0.5cc of 0.5% bupivacaine, delivered superficially to the area overlying the greater occipital nerve
Drug: Bupivacaine
0.5 cc of 0.5% bupivacaine injected intradermally

Primary Outcome Measures :
  1. Headache freedom [ Time Frame: 30 minutes ]
    Pain assessed using the following scale: "severe," "moderate," "mild," or "none"

Secondary Outcome Measures :
  1. Sustained headache relief [ Time Frame: 48 hours ]
    Attaining a headache level of "mild" or "none" within one hour of procedure and maintaining this for 48 hours without use of additional medication

  2. Satisfaction [ Time Frame: 48 hours ]
    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?

Other Outcome Measures:
  1. 0-10 verbal pain score [ Time Frame: 48 hours ]
    0-10 pain scores will be obtained in the ED and after ED discharge

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • ED patient with acute migraine or probable migraine
  • Fail first line therapy with metoclopramide

Exclusion Criteria:

  • Can't obtain consent
  • Concern for secondary headache
  • Skull defect
  • Propensity for bleeding
  • Overlying infection
  • Pregnancy
  • Allergy, intolerance study medication

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT02665273

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United States, New York
Montefiore Medical Center
Bronx, New York, United States, 10467
Sponsors and Collaborators
Montefiore Medical Center
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Principal Investigator: Benjamin W Friedman, MD, MS Albert Einstein College of Medicine

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Responsible Party: Benjamin W. Friedman, MD, PI, Montefiore Medical Center Identifier: NCT02665273     History of Changes
Other Study ID Numbers: 2015-4754
First Posted: January 27, 2016    Key Record Dates
Last Update Posted: August 31, 2018
Last Verified: August 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes

Additional relevant MeSH terms:
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Migraine Disorders
Headache Disorders, Primary
Headache Disorders
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Anesthetics, Local
Central Nervous System Depressants
Physiological Effects of Drugs
Sensory System Agents
Peripheral Nervous System Agents