枕大神经阻滞治疗头痛。证据回顾。
Greater occipital nerve block in the treatment of headaches. Review of evidence.
机构信息
Servicio de Neurología, Hospital Universitario San Pedro, Logroño, La Rioja, España.
Servicio de Neurología, Hospital Universitario San Pedro, Logroño, La Rioja, España.
出版信息
Med Clin (Barc). 2023 Aug 11;161(3):113-118. doi: 10.1016/j.medcli.2023.04.001. Epub 2023 Apr 24.
INTRODUCTION
Peripheral nerve blocks have been a common treatment for multiple headaches. By far, the greater occipital nerve block is the most used and with the stronger body of evidence in routine clinical practice.
METHODS
We searched Pubmed Meta-Analysis/Systematic Review, in the last 10 years. Of these results, meta-analyses, and in the absence of these systematic reviews, assessing Greater Occipital Nerve Block in headache has been selected for review.
RESULTS
We identified 95 studies in Pubmed, 13 that met the inclusion criteria.
CONCLUSION
Greater occipital block is an effective and safe technique, easy to perform and which has shown its usefulness in migraine, cluster headache, cervicogenic headache and Post-dural puncture headache. However, more studies are needed to clarify its long-term efficacy, its place in clinical treatment, the possible difference between different anaesthetics, the most convenient dosage and the role of concomitant use of corticosteroids.
简介
周围神经阻滞已成为治疗多种头痛的常用方法。到目前为止，枕大神经阻滞是最常用的，并且在常规临床实践中有更强的证据支持。
方法
我们在过去 10 年中在 Pubmed Meta 分析/系统评价中进行了搜索。在这些结果中，选择了评估枕大神经阻滞治疗头痛的荟萃分析，并且在缺乏这些系统评价的情况下进行了评估。
结果
我们在 Pubmed 中发现了 95 项研究，其中 13 项符合纳入标准。
结论
枕大神经阻滞是一种有效且安全的技术，易于操作，并且已证明在偏头痛、丛集性头痛、颈源性头痛和硬脊膜穿刺后头痛中有用。然而，需要更多的研究来阐明其长期疗效、在临床治疗中的地位、不同麻醉剂之间的可能差异、最方便的剂量以及皮质类固醇的联合使用的作用。
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