Evidence map›Paper›PMID 34941197›Full record

SynthesisMedicine2021

Efficacy of greater occipital nerve block for pain relief in patients with postdural puncture headache: A meta-analysis.

Ying-Jen Chang, Kuo-Chuan Hung, I-Wen Chen, Chi-Lin Kuo, I-Chia Teng, Ming-Chung Lin, Ming Yew, Shu-Wei Liao, Chung-Yi Wu, Chia-Hung Yu and 2 more

Open access · goldAbstract readMeta-Analysis
In one paragraph

Synthesis in Medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
2.3field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 14 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 2 institutions in 1 country.

Ying-Jen ChangDepartment of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
Kuo-Chuan HungDepartment of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
I-Wen ChenDepartment of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
Chi-Lin KuoDepartment of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
I-Chia TengDepartment of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
Ming-Chung LinDepartment of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
Ming YewDepartment of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
Shu-Wei LiaoDepartment of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
Chung-Yi WuDepartment of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
Chia-Hung YuDepartment of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
Kuo-Mao LanDepartment of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
Cheuk-Kwan SunDepartment of Emergency Medicine, E-Da Hospital, Kaohsiung City, Taiwan.ORCID 0000-0002-2524-9684
Chi Mei Medical Center · TWE-Da Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis study aimed at assessing the therapeutic effectiveness of greater occipital nerve block (GONB) against postdural puncture headache (PDPH).

methodsStudies investigating analgesic effects of GONB against PDPH in adults were retrieved from the MEDLINE, EMBASE, Google scholar, and Cochrane central databases from their inception dates to May, 2021. Pain score at postprocedural 24 hours was the primary endpoint, while secondary endpoints were pain score at postprocedural 1 hour and 12 hours as well as the risk of intervention failure.

resultsOf the 7 studies (randomized controlled trials [RCTs], n = 4; non-RCTs, n = 3) that recruited 275 patients, 2 investigated female patients undergoing cesarean section and the other 5 were conducted in both obstetric and nonobstetric settings. Pooled results showed a lower mean pain score at 24 hours (i.e., primary outcome) (mean difference [MD] = -2.66, 95%: CI: -3.98 to -1.33, P < .001; I2 = 97%, 6 studies), 1 hour (MD = -4.23, 95% confidence interval [CI]: -5.08 to -3.37, P < .00001; I2 = 86%, 5 studies), and 6 hours (MD = -2.78, 95% CI: -4.99 to -0.57, P = .01; I2 = 98%, 4 studies) in patients with GONB compared to those without. Trial sequential analysis supported the robustness of evidence at postprocedural 24 hours. The use of GONB also decreased the risk of intervention failure (relative ratio [RR] = 0.4, 95% CI: 0.19 to 0.82, P = .01; I2 = 96%, 6 studies, 277 patients).

conclusionOur results suggested a therapeutic effect of greater occipital nerve block against postdural puncture headache up to postprocedural 24 hours. Further large-scale studies are warranted to evaluate its therapeutic benefit beyond the acute stage.

Indexed as

Anesthesia, ConductionAdultAnalgesia, EpiduralAnalgesia, ObstetricalAnesthetics, LocalFemaleHumansNerve BlockPainPeripheral NervesPost-Dural Puncture HeadachePregnancyTreatment OutcomeAnesthetics, Local

Identifiers

PMID34941197
PMCPMC8701447
OpenAlexW4200132672

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.