Ertilav Esra, Aydın Osman Nuri
Department of Neurology & Algology, Adnan Menderes University Medical Faculty, 09100 Aydin, Turkey.
Department of Anesthesiology & Algology, Adnan Menderes University Medical Faculty, 09100 Aydin, Turkey.
J Oral Facial Pain Headache. 2024 Sep;38(3):100-107. doi: 10.22514/jofph.2024.031. Epub 2024 Sep 12.
The aim of this study was to compare the effectiveness of greater occipital nerve (GON) block and pulsed radiofrequency (PRF) treatment in chronic migraine patients. Seventy patients admitted to the Neurology and Algology outpatient clinic between September 2023 and December 2023 and diagnosed with chronic migraine according to The International Classification of Headache Disorders 3rd Edition (ICHD-3) criteria were included in the study. Patients were randomized into 2 groups to receive ultrasound-guided repeated GON block and PRF. Visual Analog Scale (VAS) scores for pain relief and Migraine Disability Assessment (MIDAS) scores for disability were recorded before the procedure and at 1st and 6th months after the procedure. In both groups, 35 patients with greater occipital nerve (GON) block, 32 patients with GON PRF, the pain scores at 1st and 6th months post-procedure were significantly lower compared to before the procedure ( < 0.001, < 0.001, respectively). VAS scores were significantly lower in the PRF group than in the GON block group at 6th month ( = 0.009). In both groups, post-procedural MIDAS scores at 1st and 6th months were significantly lower compared to before the procedure ( < 0.001, < 0.001, respectively). In the GON PRF group, MIDAS scores at 6th month were significantly lower than MIDAS scores at 1st month ( < 0.001). MIDAS scores were significantly lower in the PRF group compared to the GON block group at 6th months ( < 0.001).Interventional procedures such as GON block and PRF are safe and effective methods in chronic migraine. PRF is a better alternative to GON block in chronic migraine with longer effectiveness.
本研究的目的是比较枕大神经（GON）阻滞和脉冲射频（PRF）治疗慢性偏头痛患者的有效性。纳入了2023年9月至2023年12月期间在神经科和疼痛门诊就诊、根据《国际头痛疾病分类》第3版（ICHD-3）标准诊断为慢性偏头痛的70例患者。患者被随机分为2组，分别接受超声引导下重复GON阻滞和PRF治疗。在治疗前、治疗后第1个月和第6个月记录视觉模拟量表（VAS）疼痛缓解评分和偏头痛残疾评估（MIDAS）残疾评分。两组中，35例行枕大神经（GON）阻滞，32例行GON PRF，治疗后第1个月和第6个月的疼痛评分均显著低于治疗前（分别为P<0.001，P<0.001）。第6个月时，PRF组的VAS评分显著低于GON阻滞组（P = 0.009）。两组中，治疗后第1个月和第6个月的MIDAS评分均显著低于治疗前（分别为P<0.001，P<0.001）。在GON PRF组中，第6个月的MIDAS评分显著低于第1个月（P<0.001）。第6个月时，PRF组的MIDAS评分显著低于GON阻滞组（P<0.001）。GON阻滞和PRF等介入治疗方法在慢性偏头痛中是安全有效的方法。在慢性偏头痛中，PRF是比GON阻滞更好的选择，其疗效更持久。
