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The effectiveness of greater occipital nerve blockade in treating acute migraine‐related headaches in emergency departments
Author(s) -
Korucu O.,
Dagar S.,
Çorbacioglu Ş. K.,
Emektar E.,
Cevik Y.
Publication year - 2018
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.12952
Subject(s) - medicine , migraine , metoclopramide , placebo , blockade , anesthesia , headaches , randomized controlled trial , surgery , vomiting , alternative medicine , receptor , pathology
Objective This study aimed to evaluate the effectiveness of a greater occipital nerve ( GON ) blockade against a placebo and classical treatments (non‐steroidal anti‐inflammatory drugs + metoclopramide) among patients who were admitted to the emergency department ( ED ) with acute migraine headaches. Method This prospective‐randomized controlled study was conducted on patients with acute migraine headaches. The patients were randomly assigned to 3 treatment groups: the GON blockade group (nerve blockade with bupivacaine), the placebo group (injection of normal saline into the GON area), and the intravenous ( IV ) treatment group ( IV dexketoprofen and metoclopramide). Sixty acute migraine attack patients were assigned to 3 groups of 20 patients each. The pain severity was assessed at 5, 15, 30, and 45 minutes with a 10‐point pain scale score ( PSS ). Results The mean decreases in the 5‐, 15‐, 30‐, and 45‐minutes PSS scores were greater in the GON blockade group than in the dexketoprofen and placebo groups. When comparing the 30‐ and 45‐minutes PSS changes, a statistically significant difference was found among the 3 groups ( P = .03 and P = .03, respectively). Conclusion A GON blockade was as effective as an IV dexketoprofen + metoclopramide treatment and superior to a placebo in patients with acute migraine headaches. Despite being an invasive procedure, a GON blockade might be an effective option for acute migraine treatment in the ED due to its rapid, easy, and safe application.