Primer baş ağrılı hastalarda büyük oksipital sinir blokajı ve erken dönem sonuçları

Amaç: Büyük oksipital sinir [greater occipital nerve (GON)] blokajı son yıllarda baş ağrılı hastalarda en sık tercih edilen periferik sinir blokajlarındandır. Bu çalışmada primer baş ağrılı hastalarda GON blokajının etkinliği değerlendirilmiştir. Gereç ve Yöntem: Bu retrospektif kohort çalışması Nisan 2021 ve Nisan 2022'de yapılmıştır. Birincil baş ağrısı bozukluğu olan yüz yirmi bir hasta dahil edilmiştir. İzlemin 1. ve 3. ayında enjeksiyon tedavisi öncesi ve sonrası baş ağrısı ataklarının süresi ve sıklığı, ağrı şiddeti ve oral ilaç tipindeki değişiklikler değerlendirildi.. Bulgular: 3. ayın sonunda migren grubunda aylık baş ağrısı atak sayısı 13’ten 5’e ve vizuel analog skala(VAS) skoru 9’dan 5’e düşmüştü. Benzer şekilde gerilim tipi baş ağrısı (GTB) grubunda aylık baş ağrısı atak sayısı 17’den 7’ye ve VAS skoru 8’den 4’e düşmüştü. Her iki grupta da tüm paremetrelerdeki iyileşmeler istatiksel olarak anlamlıydı. Sonuç: GON bloğu, düşük maliyetli, hızlı ve minimal invaziv bir yöntemdir ve verilerimiz, bu yöntemin baş ağrısı ataklarının sayısını, sıklığını ve şiddetini azaltarak, ağızdan ilaç tedavisine dirençli migren ve GTB hastalarında etkili bir tedavi yöntemi olabileceğini göstermiştir. Sonuç olarak GON blokajı klinisyenlerce ağızdan ilaç tedavisine dirençli migren ve GTB hastalarında öncelikli bir tedavi seçeneği olarak düşünülmelidir.

Anahtar Kelimeler:

Primer Baş Ağrısı, Periferik Sinir Blokajı, Büyük Oksipital Sinir Blokajı

Greater occipital nerve block in patients with primary headache and early term results

Purpose: Peripheral nerve blocks have long been used in headache treatment and greater occipital nerve (GON) blocks are the most frequently preferred peripheral nerve blocks in patients with headaches in the past years. In this study, the efficacy of GON blocks in patients with primary headache disorders was evaluated. Materials and Methods: This retrospective cohort study was undertaken in April 2021 and April 2022. One hundred twenty-one patients with primary headache disorders were included. Changes in the duration and frequency of headache attacks, pain severity, and type of oral medication before and after the injection treatment during the first and third months of follow-up were evaluated. Results: The number of headache attacks decreased from 13 to 5 and the visual analogue scale(VAS) score decreased from 9 to 5 at the end of the third month in the migraine group. Similarly, the number of headache attacks decreased from 17 to 7 and the VAS score decreased from 8 to 4 in tension-type headache (TTH) group. Improvements in all parameters were found to be statistically significant in both groups. Conclusion: GON block is a low-cost, rapid and minimally invasive treatment, and our data support that this method can be an effective treatment option in patients with migraine and TTH who are resistant to oral medication by reducing the number, frequency and severity of headache attacks. In conclusion, GON blockade should be considered by clinicians as a primary treatment option in patients with migraine and TTH resistant to oral medication.

Keywords:

Primary Headache, Peripheral nerve blockade, Greater Occipital Nerve Block,

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