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March 13, 2026Open Access

Does Bupivacaine Concentration Matter? A Comparative Study of 0.25% and 0.5% Bupivacaine in Greater Occipital Nerve Blocks

Key Points

The aim is to evaluate the effectiveness of 0.25% and 0.5% bupivacaine in greater occipital nerve blocks for chronic migraine treatment.
Retrospective analysis of 72 patients with chronic migraine
Patients divided into 0.25% and 0.5% bupivacaine groups
Weekly nerve blocks for four weeks, then monthly for six months
Pain measured using Visual Analogue Scale at multiple time points
Both concentrations significantly reduced VAS scores over time
Group 1 decreased from 8.49 to 4.80 at one month and 4.21 at six months
Group 2 decreased from 8.65 to 4.35 at one month and 3.2 at six months
Reductions within each group were statistically significant

Abstract

Objective: This study aimed to assess the effectiveness of two concentrations of bupivacaine (0.25% and 0.5%) in greater occipital nerve (GON) blocks in patients with chronic migraine.Method: In this retrospective analysis, 72 patients with chronic migraine, treated between 2019 and 2021, were divided into two groups: Group 1 (0.25% bupivacaine) and Group 2 (0.5% bupivacaine). Patients received weekly GON blocks for four weeks, followed by monthly sessions for six months. Pain levels were measured using the Visual Analogue Scale (VAS) at the initial visit (VAS-1), after the first month (VAS-2), and at six months (VAS-3).Results: Both bupivacaine concentrations significantly reduced VAS scores over time. In Group 1, the mean VAS score decreased from 8.49 at baseline to 4.80 at the first month and 4.21 at six months. In Group 2, the VAS scores decreased from 8.65 to 4.35 at the first month and 3.2 at six months. The reductions within each group were statistically significant (p

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