Comparing Different Doses of Bupivacaine for Greater Occipital Nerve Block to Treat Post-Traumatic Headache in Veterans

What this Trial Is About

This research aims to evaluate the acute and subacute sensations experienced on the scalp when different concentrations of bupivacaine are injected for greater occipital nerve blockade in Veterans with post-traumatic headache PTH. Military Servicemembers and Veterans are at higher risk of traumatic brain injury, which can lead to PTH, often resembling migraine. Current treatments have limitations, so this study explores a nerve blockade method that might offer relief. Participants will receive three different concentrations of bupivacaine injections around the bilateral greater occipital nerves, administered one week apart in a randomized order. The concentrations tested include 0.0%, 0.01%, 0.05%, 0.1%, and 0.5% in various combinations to identify which lower dose best mimics the sensations of the full dose 0.5% for use in a future trial. During the study, participants will report on the quality, intensity, distribution, and duration of sensations during and after each injection, up to one week following. Researchers will monitor for any adverse events from the first injection until two weeks after the last injection. The study involves multiple injections spaced one week apart, with detailed sensory assessments to measure the nerve blockade effects.

Greater Occipital Nerve Blockade in Veterans With Post-concussion Headache: Sub-study 1