Neurology Department, Ümraniye Research and Training Hospital, İstanbul, Türkiye.
Algology Department, Ümraniye Research and Training Hospital, İstanbul, Türkiye.
BMC Neurol. 2024 Sep 4;24(1):311. doi: 10.1186/s12883-024-03816-8.
Migraine is a primary headache defined as moderate-to-severe pain lasting 4 to 72 h, ranking 2nd among the disabling conditions for both genders regardless of the age and the greater occipital nerve (GON) block has been reported as an efficient treatment method for migraine. The present study aims to evaluate and compare the efficiency of the two methods of GON block, i.e., the ultrasound (US)-guided technique and the landmark-based technique.
Having a prospective and randomized design, the study assigned the patients with chronic migraine into two groups after which a neurologist performed landmark-based GON block in the first group while an algologist performed US-guided GON block in the second group. During the 3-month follow-up period, the number of days with pain, the duration of pain, the number of analgesic drugs taken in a month, and Visual Analogue Scale (VAS) scores were compared with the values before treatment and at the 1st week, 1st month, and 3rd month after treatment.
US-guided GON block group included 34 patients while there were 32 patients in the landmark-based GON block group. US-guided GON block group showed significantly reduced VAS scores and frequency of attacks compared to the landmark-based GON block group at Month 1 after the procedure. After a 3-month follow-up period of the two groups, the frequency of attacks, analgesic intake and the duration of attacks were lower in both groups compared to the baseline. At 3-month follow-up, the mean of VAS scores decreased from 9,47 ± 2,69 to 4,67 ± 1,9 in US-guided GON block group and from 9,46 ± 0,98 to 7 ± 2,5 in the landmark-based GON block group.
It was determined that both US-guided and landmark-based GON block were efficient techniques in patients with chronic migraine. US-guided GON block technique resulted in lower VAS scores, shorter durations of pain, lower frequencies of attack, and lower intake of analgesics compared to the landmark-based GON block technique.
偏头痛是一种原发性头痛，定义为中度至重度疼痛持续 4 至 72 小时，无论年龄大小，在两性中都是仅次于第二位的致残性疾病，而枕大神经（GON）阻滞已被报道为偏头痛的一种有效治疗方法。本研究旨在评估和比较 GON 阻滞的两种方法，即超声（US）引导技术和基于地标技术的方法。
前瞻性随机设计，将慢性偏头痛患者分为两组，然后由神经科医生对第一组进行基于地标 GON 阻滞，由麻醉师对第二组进行 US 引导 GON 阻滞。在 3 个月的随访期间，比较疼痛天数、疼痛持续时间、每月使用的镇痛药数量和视觉模拟量表（VAS）评分与治疗前及治疗后第 1 周、第 1 个月和第 3 个月的值。
US 引导 GON 阻滞组纳入 34 例患者，基于地标 GON 阻滞组纳入 32 例患者。与基于地标 GON 阻滞组相比，US 引导 GON 阻滞组在术后第 1 个月的 VAS 评分和发作频率显著降低。两组患者在 3 个月的随访期间，与基线相比，发作频率、镇痛药摄入量和发作持续时间均较低。在 3 个月的随访中，US 引导 GON 阻滞组的 VAS 评分从 9.47±2.69 降至 4.67±1.9，基于地标 GON 阻滞组从 9.46±0.98 降至 7±2.5。
US 引导和基于地标 GON 阻滞在慢性偏头痛患者中均为有效技术。与基于地标 GON 阻滞技术相比，US 引导 GON 阻滞技术可降低 VAS 评分、疼痛持续时间、发作频率和镇痛药摄入量。
