Karaoğlan Mustafa, İnan Levent Ertuğrul
Ordu State Hospital, Department of Algology, Ordu, Turkey.
Ministry Of Health Ankara Research and Training Hospital, Neurology, Ankara, Turkey.
Clin Neurol Neurosurg. 2022 Apr;215:107190. doi: 10.1016/j.clineuro.2022.107190. Epub 2022 Mar 1.
The aim of this retrospective study was to compare the efficacy and complications of ultrasound-guided block (C2GON) at the level of C2 and block performed from the distal occiput level (DOGON) as the greater occipital nerve progresses superficially to the obliquus capitis inferior muscle in migraine patients.
63 patients were included in this retrospective study. For C2GON blockade, 2 units of 4 ml 0.5% bupivacaine were prepared for bilateral administration to 32 patients. For DOGON, two 1.5 ml 0.5% bupivacaine was prepared bilaterally for each patient. The patients were evaluated in terms of pain intensity and frequency, analgesic use, and any side effects before the injection and at the 1st and 3rd months after the last treatment.
When we compared C2GON block and DOGON block in our study, we found that both blocks were effective for 3 months. The reduction rates in the C2GON and DOGON groups were 75.3% and 59% in the number of severe attacks, 63.9% and 59.1% in the total analgesic use, 71.1% and 56.25% in the triptan use, 78% and 60% in the number of days with severe headache, 63.4% and 50.3% in the duration of headache. The decrease in the highest VAS score was 48.1% in the group with C2GON, while it was 53% in the group with DOGON.
Current findings have shown that both C2GON and DOGON blockades are effective in the treatment of migraine for 3 months.
本回顾性研究的目的是比较在偏头痛患者中,当枕大神经在头下斜肌表面浅出时,C2水平超声引导阻滞(C2GON)与从枕骨远端水平进行的阻滞(DOGON)的疗效和并发症。
本回顾性研究纳入了63例患者。对于C2GON阻滞,准备2支4ml 0.5%布比卡因用于32例患者的双侧注射。对于DOGON阻滞,为每位患者双侧准备2支1.5ml 0.5%布比卡因。在注射前以及最后一次治疗后的第1个月和第3个月,对患者进行疼痛强度和频率、镇痛药使用情况以及任何副作用方面的评估。
在我们的研究中比较C2GON阻滞和DOGON阻滞时,我们发现两种阻滞在3个月内均有效。C2GON组和DOGON组中,严重发作次数的减少率分别为75.3%和59%,总镇痛药使用量的减少率分别为63.9%和59.1%,曲坦类药物使用量的减少率分别为71.1%和56.25%,严重头痛天数的减少率分别为78%和60%,头痛持续时间的减少率分别为63.4%和50.3%。C2GON组最高视觉模拟评分(VAS)的降低率为48.1%,而DOGON组为53%。
目前的研究结果表明,C2GON和DOGON阻滞在偏头痛治疗中3个月内均有效。