{"title":"超声引导下经鼻蝶腭神经节和枕大神经近端阻滞治疗慢性偏头痛的疗效比较","authors":"Selin Balta, A. U. Uca, F. Odabaş, A. Demir","doi":"10.54029/2023dpf","DOIUrl":null,"url":null,"abstract":"Background & Objective: A need exists for prophylactic treatment options for chronic migraine. Our aim was to evaluate and compare the effect of greater occipital nerve (GON) and transnasal sphenopalatine ganglion (SPG) blockade on headache days, responder rate, attack severity, attack frequency, and medication overuse in patients with chronic migraine.\nMethods: This was a retrospective study. The GON blockade was performed at the proximal level under ultrasound guidance with 1.5 cc 0.5% bupivacaine, and the SPG blockade was performed transnasally with 0.5 cc 0.5% bupivacaine applied for 30 minutes with swab sticks. Patients who completed bilateral blocks applied in four weekly sessions were included in the analysis.\nResults: Seventy patients (GON=37, SPG=33) were included in the study. Both groups showed a significant improvement in the number of days with headache, severity of attacks, and frequency of attacks at the first- and third-month follow-up visits compared to the baseline (p<0.001). Responder rates were similar at the first- and third-month follow-up visits (r= 3.707, p=0.054; r=0.071, p=0.790, respectively). At the third-month follow-up, the prevalence of medication overuse decreased from 78% to 13% in the GON group and from 57% to 9% in the SPG group, and these differences were statistically significant (p<0.001 for both groups). No significant difference was noted in efficacy between the treatment groups (p=0.714). No significant adverse effects occurred in either group.\nConclusion: Both proximal GON blockade and minimally invasive SPG blockade are effective and safe options for prophylaxis in patients with chronic migraine.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":" ","pages":""},"PeriodicalIF":0.2000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparison of outcomes of transnasal sphenopalatine ganglion and ultrasound-guided proximal greater occipital nerve blockades in chronic migraine\",\"authors\":\"Selin Balta, A. U. Uca, F. Odabaş, A. Demir\",\"doi\":\"10.54029/2023dpf\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Background & Objective: A need exists for prophylactic treatment options for chronic migraine. Our aim was to evaluate and compare the effect of greater occipital nerve (GON) and transnasal sphenopalatine ganglion (SPG) blockade on headache days, responder rate, attack severity, attack frequency, and medication overuse in patients with chronic migraine.\\nMethods: This was a retrospective study. The GON blockade was performed at the proximal level under ultrasound guidance with 1.5 cc 0.5% bupivacaine, and the SPG blockade was performed transnasally with 0.5 cc 0.5% bupivacaine applied for 30 minutes with swab sticks. Patients who completed bilateral blocks applied in four weekly sessions were included in the analysis.\\nResults: Seventy patients (GON=37, SPG=33) were included in the study. Both groups showed a significant improvement in the number of days with headache, severity of attacks, and frequency of attacks at the first- and third-month follow-up visits compared to the baseline (p<0.001). Responder rates were similar at the first- and third-month follow-up visits (r= 3.707, p=0.054; r=0.071, p=0.790, respectively). At the third-month follow-up, the prevalence of medication overuse decreased from 78% to 13% in the GON group and from 57% to 9% in the SPG group, and these differences were statistically significant (p<0.001 for both groups). No significant difference was noted in efficacy between the treatment groups (p=0.714). No significant adverse effects occurred in either group.\\nConclusion: Both proximal GON blockade and minimally invasive SPG blockade are effective and safe options for prophylaxis in patients with chronic migraine.\",\"PeriodicalId\":49757,\"journal\":{\"name\":\"Neurology Asia\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.2000,\"publicationDate\":\"2023-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neurology Asia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.54029/2023dpf\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurology Asia","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.54029/2023dpf","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景与目的:慢性偏头痛需要预防性治疗方案。我们的目的是评估和比较枕大神经(GON)和经鼻蝶腭神经节(SPG)阻断对慢性偏头痛患者头痛天数、反应率、发作严重程度、发作频率和药物过度使用的影响。方法:本研究为回顾性研究。在超声引导下,用1.5 cc 0.5%布比卡因在近端水平进行GON阻断,用0.5 cc 0.5%布哌卡因经鼻用棉签棒进行SPG阻断30分钟。在每周四次疗程中完成双侧阻断的患者被纳入分析。结果:70名患者(GON=37,SPG=33)被纳入研究。与基线相比,两组在第一个月和第三个月随访时头痛天数、发作严重程度和发作频率均有显著改善(p<0.001)。第一个月随访和第三次随访的应答率相似(分别为r=3.707,p=0.054;r=0.071,p=0.790)。在第三个月的随访中,GON组药物过度使用的发生率从78%降至13%,SPG组从57%降至9%,这些差异具有统计学意义(两组均<0.001)。治疗组间疗效无显著差异(p=0.714)。两组均未出现显著不良反应。结论:近端GON阻断和微创SPG阻断是预防慢性偏头痛有效、安全的选择。
Comparison of outcomes of transnasal sphenopalatine ganglion and ultrasound-guided proximal greater occipital nerve blockades in chronic migraine
Background & Objective: A need exists for prophylactic treatment options for chronic migraine. Our aim was to evaluate and compare the effect of greater occipital nerve (GON) and transnasal sphenopalatine ganglion (SPG) blockade on headache days, responder rate, attack severity, attack frequency, and medication overuse in patients with chronic migraine.
Methods: This was a retrospective study. The GON blockade was performed at the proximal level under ultrasound guidance with 1.5 cc 0.5% bupivacaine, and the SPG blockade was performed transnasally with 0.5 cc 0.5% bupivacaine applied for 30 minutes with swab sticks. Patients who completed bilateral blocks applied in four weekly sessions were included in the analysis.
Results: Seventy patients (GON=37, SPG=33) were included in the study. Both groups showed a significant improvement in the number of days with headache, severity of attacks, and frequency of attacks at the first- and third-month follow-up visits compared to the baseline (p<0.001). Responder rates were similar at the first- and third-month follow-up visits (r= 3.707, p=0.054; r=0.071, p=0.790, respectively). At the third-month follow-up, the prevalence of medication overuse decreased from 78% to 13% in the GON group and from 57% to 9% in the SPG group, and these differences were statistically significant (p<0.001 for both groups). No significant difference was noted in efficacy between the treatment groups (p=0.714). No significant adverse effects occurred in either group.
Conclusion: Both proximal GON blockade and minimally invasive SPG blockade are effective and safe options for prophylaxis in patients with chronic migraine.
期刊介绍:
Neurology Asia (ISSN 1823-6138), previously known as Neurological Journal of South East Asia (ISSN 1394-780X), is the official journal of the ASEAN Neurological Association (ASNA), Asian & Oceanian Association of Neurology (AOAN), and the Asian & Oceanian Child Neurology Association. The primary purpose is to publish the results of study and research in neurology, with emphasis to neurological diseases occurring primarily in Asia, aspects of the diseases peculiar to Asia, and practices of neurology in Asia (Asian neurology).