Objectives: This study aims to investigate the efficiency of a single and repeated greater occipital nerve (GON) block using lidocaine in the treatment of triptan-overuse headache (TOH), whose importance has increased lately.
Materials And Methods: In the study, 105 consecutive subjects diagnosed with TOH were evaluated. The subjects were randomized into three groups. In Group 1 (n=35), only triptan was abruptly withdrawn. In Group 2 (n=35), triptan was abruptly withdrawn and single GON block was performed. In Group 3 (n=35), triptan was abruptly withdrawn and three-stage GON block was performed. All patients were injected bilaterally with a total amount of 5 cc 1% lidocaine in each stage. During follow-up, the number of headache days per month, the severity of pain (VAS), the number of triptans used, and hsCRP and IL-6 levels were recorded three times; in the pretreatment period, in the second month post-treatment, and in the fourth month post-treatment. They were then compared.
Results: There was a statistically significant difference in the post-treatment fourth month in comparison with the pretreatment period in Group 3 (P<.05). Compared to Group 1, the number of headache days, VAS, and decrease in triptan need in Group 3 was statistically significant compared to Group 2 (P<.05). Compared to pretreatment, in the fourth month post-treatment, both hsCRP and IL-6 levels were lower only in Group 3 (P<.05).
Conclusions: We are of the opinion that repeated GON block in addition to the discontinuation of medication has significant efficacy for TOH cases.
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Article Synopsis
- A meta-analysis was conducted to evaluate the effectiveness of greater occipital nerve (GON) block in reducing pain for those suffering from acute migraines.
- The analysis included four randomized controlled trials with a total of 224 patients, showing that GON block significantly reduced pain scores at 30 and 45 to 60 minutes post-intervention, but not at the earliest 0 to 15 minutes.
- While GON block can help decrease pain intensity for acute migraine sufferers, it did not have a significant effect on sustained headache relief or the need for rescue medication.
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