Sonographic visualization and ultrasound-guided blockade of the greater occipital nerve: a comparison of two selective techniques confirmed by anatomical.

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Sonographic visualization and ultrasound-guided blockade of the greater occipital nerve: a comparison of two selective techniques confirmed by anatomical dissection  M. Greher, B. Moriggl, M. Curatolo, L. Kirchmair, U. Eichenberger  British Journal of Anaesthesia  Volume 104, Issue 5, Pages 637-642 (May 2010) DOI: 10.1093/bja/aeq052 Copyright © 2010 The Author(s) Terms and Conditions

Fig 1 Transducer positions for ultrasound-guided blocks of the GON. 1, Classic block site at the superior nuchal line; 2, new block site at C2. British Journal of Anaesthesia 2010 104, 637-642DOI: (10.1093/bja/aeq052) Copyright © 2010 The Author(s) Terms and Conditions

Fig 2 Schematic drawing of the course of the GON. 1, Classic block site medial to the occipital artery at the superior nuchal line; 2, new block site over the obliquus capitis inferior muscle (grey) at C2. British Journal of Anaesthesia 2010 104, 637-642DOI: (10.1093/bja/aeq052) Copyright © 2010 The Author(s) Terms and Conditions

Fig 3 Ultrasound image obtained by the transducer position 2 in Figure 1. 1, Obliquus capitis inferior muscle; BONE, lamina of C2; GON, greater occipital nerve. British Journal of Anaesthesia 2010 104, 637-642DOI: (10.1093/bja/aeq052) Copyright © 2010 The Author(s) Terms and Conditions

Fig 4 The anatomical dissection shows four injection sites. The upper two are at the classical block site at position 1 in Figure 2. The lower two are at the new block site at position 2 in Figure 2. The tips of all four needles are in the GON, and the nerve is coloured by ICG. British Journal of Anaesthesia 2010 104, 637-642DOI: (10.1093/bja/aeq052) Copyright © 2010 The Author(s) Terms and Conditions

Fig 5 Ultrasound image in a living subject according to transducer position 2 in Figure 1. 1, Obliquus capitis inferior muscle; BONE, lamina of C2; GON, greater occipital nerve; VA, vertebral artery with Doppler signal inside. British Journal of Anaesthesia 2010 104, 637-642DOI: (10.1093/bja/aeq052) Copyright © 2010 The Author(s) Terms and Conditions