a Department of Neurology , University of Health Sciences Dr. Lütfi Kırdar Kartal Training and Research Hospital , Istanbul , Turkey.
b Department of Public Health , Istanbul Medeniyet University , Istanbul , Turkey.
Curr Med Res Opin. 2019 May;35(5):909-915. doi: 10.1080/03007995.2018.1532403. Epub 2018 Oct 31.
Nerve injections have been used for the acute and preventive treatment of migraine in recent decades. Most of these injections focused on greater occipital nerve (GON) blockade. However, few studies were placebo controlled, and only a few of them investigated GON and supraorbital nerve (SON) blockade together. This study aimed to evaluate the efficacy of GON and SON blockade with local anesthetics for the preventive treatment of migraine without aura.
Eighty-seven patients diagnosed with migraine without aura were included in the study. Patients were divided randomly. One group was injected with 1% lidocaine, the other group was injected with 0.9% saline. GON and SON injections were done bilaterally. The injections were repeated weekly for 3 weeks. Patients were followed up for 2 months to assess clinical response.
Seventy-one patients completed the study. After 2 months, the number of headache days decreased significantly from 12.8 ± 10.9 to 5.3 ± 7.4, and VAS decreased from 8.3 ± 1.0 to 5.5 ± 1.9 in the blockade group. The number of headache days decreased from 12.4 ± 10.3 to 7.5 ± 7.2 and VAS decreased from 8.2 ± 1.1 to 7.4 ± 1.3 in the placebo group. Response was seen in 65.1% of the patients in the blockade group (65.4% for episodic migraine, 64.7% for chronic migraine) and 28.6% of the patients in the placebo group. The difference was significant.
The results suggest that GON and SON blockade with lidocaine was more effective than the placebo in the prophylactic treatment of both episodic and chronic migraine.
近几十年来，神经注射已被用于急性和预防性偏头痛治疗。这些注射大多集中在枕大神经（GON）阻滞上。然而，很少有研究是安慰剂对照的，而且只有少数研究同时调查了 GON 和眶上神经（SON）阻滞。本研究旨在评估局部麻醉剂阻滞 GON 和 SON 治疗无先兆偏头痛的预防性疗效。
本研究纳入了 87 例无先兆偏头痛患者。患者被随机分组。一组注射 1%利多卡因，另一组注射 0.9%生理盐水。双侧行 GON 和 SON 注射。每周重复注射 3 周。随访 2 个月以评估临床反应。
71 例患者完成了研究。2 个月后，阻滞组头痛天数从 12.8±10.9 显著减少至 5.3±7.4，VAS 评分从 8.3±1.0 减少至 5.5±1.9。安慰剂组头痛天数从 12.4±10.3 减少至 7.5±7.2，VAS 评分从 8.2±1.1 减少至 7.4±1.3。阻滞组 65.1%（发作性偏头痛 65.4%，慢性偏头痛 64.7%）的患者有反应，安慰剂组 28.6%的患者有反应。差异有统计学意义。
结果表明，利多卡因阻滞 GON 和 SON 在预防治疗发作性和慢性偏头痛方面比安慰剂更有效。
