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Acta Neurol. Scand. · Sep 2018
Randomized Controlled TrialThe effectiveness of greater occipital nerve blockade in treating acute migraine-related headaches in emergency departments.
- O Korucu, S Dagar, Ş K Çorbacioglu, E Emektar, and Y Cevik.
- Department of Neurology, University of Health Sciences, Kecioren Training and Research Hospital, Ankara, Turkey.
- Acta Neurol. Scand. 2018 Sep 1; 138 (3): 212-218.
ObjectiveThis 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.MethodThis 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).ResultsThe 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).ConclusionA 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.© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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