Table 2

Constituents and volumes for individual nerve blocks

NerveConstituents per injection (volume injected, mL)
Greater occipitalMethylprednisolone 40 mg/mL* (2 mL)
Lidocaine 2%† (1 mL)
Bupivacaine 0.5%‡ (1 mL)
Total injection volume=4 mL
Methylprednisolone can be omitted and volume made up with lidocaine and/or bupivacaine
If using a combination of the both lidocaine and bupivacaine, the recommended volume ratio (lidocaine/bupivacaine) is 1:1–1:3
Lesser occipitalLidocaine 2% (1 mL)
Bupivacaine 0.5% (1 mL)
Total injection volume=2 mL
SupraorbitalLidocaine 2% (0.5 mL)
Bupivacaine 0.5% (0.5 mL)
Total injection volume=1 mL
  • *Methylprednisolone acetate maximum dose 160 mg per session.

  • †Lidocaine maximum dose: 4.5 mg/kg, not to exceed 300 mg per session (without vasoconstrictor).

  • ‡Bupivacaine maximum dose: 2.5 mg/kg, not to exceed 175 mg per session (without vasoconstrictor).