Kronik Gerilim Tipi Baş Ağrısı Tedavisinde Periferik Sinir Blokajı ve Tetik Nokta Enjeksiyonlarının Etkinliği

Purpose: Greater and lesser occipital nerve blockade (GONB/LONB) using local anesthetics with and without corticosteroids, and supraorbital and supratrochlear nerve blockade (STNB) using local anesthetics and trigger point injections (TPI) are commonly employed for the treatment of primary and secondary headache disorders. In this study, we aimed to investigate the efficiency of peripheral nerve blockade in the treatment of chronic tension-type headache. Patients and Methods: A total of 174 patients who received GONB and/or STNB with or without TPI between June 2013 and October 2016 were included in this study. The patients were divided into three groups as GONB, GONB+STNB, GONB+STNB+TPI and followed up for four weeks with VAS score. In the GONB alone group, triamcinolone and bupivacaine were used, and in the remaining two groups, only bupivacaine was administered. Results: The mean age of the study population was 43.2±7.2 years. Female dominance was present. There were no statistically significant differences between the three groups regarding age and gender. Furthermore, headache frequency and VAS scores of the groups did not significantly differ before treatment; however, significant differences were observed (in both) between and within groups after treatment. The response rates were significantly higher (50% and 75%) in the last treatment group. Conclusion: In this study, TPI combined with GONB and STNB was superior to GONB+STNB and GONB alone regarding headache frequency. We also found that in all groups, post-treatment VAS scores and headache frequency were lower compared to pretreatment values.