Department of Medicine, Jinnah Sindh Medical University, Karachi, 75510, Pakistan.
Jinnah Sindh Medical University, Rafiqi H J Shaheed Road, Karachi, 75510, Pakistan.
BMC Neurol. 2024 Sep 7;24(1):330. doi: 10.1186/s12883-024-03834-6.
BACKGROUND & AIMS: Chronic migraine poses a global health burden, particularly affecting young women, and has substantial societal implications. This study aimed to assess the efficacy of Greater Occipital Nerve Block (GONB) in individuals with chronic migraine, focusing on the impact of local anesthetics compared with placebo.
A meta-analysis and systematic review were conducted following the PRISMA principles and Cochrane Collaboration methods. Eligible studies included case-control, cohort, and randomized control trials in adults with chronic migraine, adhering to the International Classification of Headache Disorders, third edition (ICHD3). Primary efficacy outcomes included headache frequency, duration, and intensity along with safety assessments.
Literature searches across multiple databases yielded eight studies for qualitative analysis, with five included in the final quantitative analysis. A remarkable reduction in headache intensity and frequency during the first and second months of treatment with GONB using local anesthetics compared to placebo has been reported. The incidence of adverse events did not differ significantly between the intervention and placebo groups.
The analysis emphasized the safety and efficacy of GONB, albeit with a cautious interpretation due to the limited number of studies and relatively small sample size. This study advocates for further research exploring various drugs, frequencies, and treatment plans to enhance the robustness and applicability of GONB for chronic migraine management.
慢性偏头痛给全球健康带来了负担，尤其影响年轻女性，并对社会产生了重大影响。本研究旨在评估大枕神经阻滞（GONB）对慢性偏头痛患者的疗效，重点关注局部麻醉剂与安慰剂相比的效果。
按照 PRISMA 原则和 Cochrane 协作组方法进行荟萃分析和系统评价。符合条件的研究包括符合国际头痛疾病分类，第三版（ICHD3）的慢性偏头痛成人的病例对照、队列和随机对照试验。主要疗效结局包括头痛频率、持续时间和强度以及安全性评估。
在多个数据库中进行文献检索，定性分析了 8 项研究，最终定量分析了 5 项研究。报告称，与安慰剂相比，在使用局部麻醉剂进行 GONB 的第一个和第二个月治疗期间，头痛强度和频率显著降低。干预组和安慰剂组不良事件的发生率无显著差异。
由于研究数量有限且样本量相对较小，该分析强调了 GONB 的安全性和有效性，但需谨慎解释。本研究主张进一步研究探索各种药物、频率和治疗方案，以增强 GONB 治疗慢性偏头痛的稳健性和适用性。
