Greater Occipital Nerve (GON) Block Note:
The patient was counseled on the risks, benefits, and alternatives to the procedure, and provided [written/verbal] consent. A timeout procedure was performed prior to initiating the procedure.
The patient was placed in a seated and the approximate location of the greater occipital nerve (GON) was identified based on landmarks (the index finger was placed on the occipital protuberance with the thumb placed on the mastoid process (either side)-measured 1/3 the distance from the occipital protuberance as the likely location of the GON). The area was cleaned appropriately using [alcohol/chlorhexadine/betadine]. Using a 23-gauge needle [3-5 mL of 1/2% lidocaine/2-4 mL of 0.25/0.5% bupivicaine] was infiltrated at the site of the GON using a 'fanning technique' (1 mL of anesthetic injected immediately adjacent to GON, 1 mL medial to the GON, and 1 mL lateral to the GON for maximal infiltration (may be repeated bilaterally)).
The patient was monitored following the procedures and reported [moderate/significant] relief in pain. The patient tolerated the procedure well without complications.
http://www.emdocs.net/pain-profiles-ed-migraine-management-the-new-kid-on-the-block/
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