Allen Sorcha M, Mookadam Farouk, Cha Stephen S, Freeman John A, Starling Amaal J, Mookadam Martina
From the Departments of Internal Medicine (SMA), Family Medicine (MM), and Neurology (AJS); and the Divisions of Biomedical Statistics and Informatics (SSC), Anaesthesiology, Physical Medicine and Rehabilitation (JAF), and Cardiovascular Diseases (FM), Mayo Clinic, Phoenix, AZ.
J Am Board Fam Med. 2018 Mar-Apr;31(2):211-218. doi: 10.3122/jabfm.2018.02.170188.
Greater occipital nerve (GON) blocks are frequently used to treat migraine headaches, although a paucity of supporting clinical evidence exists. The objective of this study was to assess the efficacy of GON block in acute treatment of migraine headache, with a focus on pain relief.
This retrospective cohort study was undertaken between January 2009 and August 2014 and included patients who underwent at least 1 GON block and attended at least 1 follow-up appointment. Change in the 11-point numeric pain rating scale (NPRS) was used to assess the response to GON block. Response was defined as "minimal" (<30% NPRS point reduction), "moderate" (31-50% NPRS point reduction), or "significant" (>50% NPRS point reduction).
A total of 562 patients met inclusion criteria; 423 were women (75%). Mean age was 58.6 ± 16.7 years. Of these 562, 459 patients (82%) rated their response to GON block as moderate or significant. No statistically significant relationship existed between previous treatment regimens and response to GON block. GON block was equally effective across the different age and sex groups.
Greater occipital block seems to be an effective option for acute management of migraine headache, with promising reductions in pain scores.
尽管支持枕大神经（GON）阻滞治疗偏头痛的临床证据较少，但该方法仍被频繁用于治疗偏头痛。本研究的目的是评估GON阻滞在偏头痛急性治疗中的疗效，重点关注疼痛缓解情况。
本回顾性队列研究于2009年1月至2014年8月进行，纳入至少接受过1次GON阻滞且至少参加过1次随访的患者。采用11分数字疼痛评分量表（NPRS）的变化来评估对GON阻滞的反应。反应被定义为“轻微”（NPRS评分降低<30%）、“中度”（NPRS评分降低31 - 50%）或“显著”（NPRS评分降低>50%）。
共有562例患者符合纳入标准；423例为女性（75%）。平均年龄为58.6±16.7岁。在这562例患者中，459例（82%）将他们对GON阻滞的反应评为中度或显著。既往治疗方案与对GON阻滞的反应之间不存在统计学上的显著关系。GON阻滞在不同年龄和性别组中同样有效。
枕大神经阻滞似乎是偏头痛急性治疗的一种有效选择，有望降低疼痛评分。
