Premium
Greater occipital nerve blockade for the treatment of chronic migraine: a randomized, multicenter, double‐blind, and placebo‐controlled study
Author(s) -
Inan L. E.,
Inan N.,
Karadaş Ö.,
Gül H. L.,
Erdemoğlu A. K.,
Türkel Y.,
Akyol A.
Publication year - 2015
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12393
Subject(s) - medicine , anesthesia , placebo , blockade , bupivacaine , blinding , migraine , chronic migraine , saline , randomized controlled trial , group b , surgery , receptor , alternative medicine , pathology
Objectives We aimed to assess the efficacy of greater occipital nerve (GON) blockade at chronic migraine ( CM ) treatment. Materials and methods Patients with CM were randomly divided into two groups of 42. GON blockade was administered four times (once per week) with saline in group A or bupivacaine in group B. After 4 weeks of treatment, blinding was removed; in group A, GON blockade was achieved using bupivacaine, while group B continued to receive bupivacaine, and blockade was administered once per month, then followed for 2 months. Primary endpoint was the difference in number of headache days, duration of headache, and pain scores. Results Seventy‐two of 84 patients completed the study. After 1 month of treatment, number of headache days had decreased from 16.9 ± 5.7 to 13.2 ± 6.7 in group A ( P = 0.035) and from 18.1 ± 5.3 to 8.8 ± 4.8 in group B ( P < 0.001), ( P = 0.004, between groups); duration of headache (hour) had decreased from 24.2 ± 13.7 to 21.2 ± 13.4 in group A ( P = 0.223) and from 25.9 ± 16.3 to 19.3 ± 11.5 in group B ( P < 0.001), ( P = 0.767, between groups). VAS score decreased from 8.1 ± 0.9 to 6.7 ± 1.6 in group A ( P = 0.002) and from 8.4 ± 1.5 to 5.3 ± 2.1 in group B ( P < 0.001), ( P = 0.004, between groups). After blinding was removed (in 2nd and 3rd month), group A exhibited similar results like group B in 3rd month. Conclusions Our results suggest that GON blockade with bupivacaine was superior to placebo and was found to be effective, safe, and cost‐effective for the treatment of CM . According to our knowledge, this is the first randomized, multicentre, double‐blind, and placebo‐controlled study in the literature in this field of work.