Zhao Wenxing, Yue Hong, Yang Liqiang, He Liangliang
Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing, China.
Department of Pain Management, Peking University Shougang Hospital, Beijing, China.
Front Pain Res (Lausanne). 2025 Aug 28;6:1556654. doi: 10.3389/fpain.2025.1556654. eCollection 2025.
This study aimed to examine the efficacy and safety of ultrasound (US)-guided superior cervical ganglion (SCG) block in conjunction with standard triptan in the management of migraine attacks.
In total, 243 subjects who received an adjunctive US-guided SCG block alongside triptan for a migraine attack were enrolled as the SCG cohort. A 1:1 propensity score based on baseline covariates was used to match 243 cases who received triptan alone as the control. The primary endpoints were pain relief and freedom from pain within 24 h after the procedure. Secondary outcomes included headache relief and freedom from pain within 2 h, monthly migraine days (MMDs), Migraine Disability Assessment (MIDAS) scores, Migraine-Specific Quality of Life questionnaire (MSQ) scores, and adverse events.
The rates of pain relief and freedom from pain at 24 h after the block were increased in the SCG cases compared to the controls {73.3% vs. 49.4%, with mean difference [MD] of 23.9% [95% confidence interval (CI): 15.5%-29.0%] and 64.2% vs. 37.4%, with MD = 26.7% [95% CI: 18.2%-31.3%], respectively}. Superiority was met, as the 95% CI fell within the superiority margin of 15%. Higher rates of pain relief and freedom from pain at 2 h following the procedure were reported in the SCG cohort (both < 0.001). At the 1-month follow-up, the SCG cohort had a greater improvement in MMDs ( < 0.01), MIDAS scores ( = 0.040), and MSQ scores ( = 0.036). There were no severe adverse events in the SCG group.
US-guided SCG block with triptan was superior to triptan alone in achieving headache remission during a migraine attack for up to 24 h, resulting in reduced migraine days and improved functional ability and life quality at the 1-month follow-up.
本研究旨在探讨超声（US）引导下的颈上神经节（SCG）阻滞联合标准曲坦类药物治疗偏头痛发作的疗效和安全性。
共有243名在偏头痛发作时接受了US引导下的SCG阻滞联合曲坦类药物治疗的受试者被纳入SCG队列。基于基线协变量使用1:1倾向评分法匹配243名仅接受曲坦类药物治疗的患者作为对照。主要终点是治疗后24小时内的疼痛缓解和无痛状态。次要结局包括2小时内的头痛缓解和无痛状态、每月偏头痛天数（MMD）、偏头痛残疾评估（MIDAS）评分、偏头痛特异性生活质量问卷（MSQ）评分以及不良事件。
与对照组相比，SCG组患者在阻滞24小时后的疼痛缓解率和无痛率有所提高{分别为73.3%对49.4%，平均差值[MD]为23.9%[95%置信区间（CI）：15.5%-29.0%]；64.2%对37.4%，MD = 26.7%[95% CI：18.2%-31.3%]}。由于95% CI落在15%的优效性界值范围内，因此达到了优效性。SCG队列在治疗后2小时的疼痛缓解率和无痛率更高（均P < 0.001）。在1个月的随访中，SCG队列的MMD（P < 0.01）、MIDAS评分（P = 0.040）和MSQ评分（P = 0.036）有更大改善。SCG组未出现严重不良事件。
US引导下的SCG阻滞联合曲坦类药物在偏头痛发作期间实现长达24小时的头痛缓解方面优于单纯使用曲坦类药物，在1个月的随访中可减少偏头痛天数，改善功能能力和生活质量。
