Kronik Migrenli Hastalarda Büyük Oksipital Sinir Bloğunun Etkinliği

Abstract

Amaç: Kronik migrende medikal tedaviden faydalanma oldukça düşük olup, hastalarda sıklıkla yoğun analjezik kullanımı olduğu bilinmektedir. Bu nedenle periferal sinir blokajı özellikle GON blokajı tedaviye dirençli kronik migren hastalarında kullanılmaya başlanmıştır. Bu çalışmada kliniğimizde medikal tedaviye dirençli kronik migren tanısı nedeniyle GON (Greater Occipital Nerve) blokajı uyguladığımız hastalarımızın 3 aylık takiplerinde başağrısı atak sıklığını, analjezik kullanımını, VAS (Vizuel Analog Skala) değerleri ve MİDAS (Migren Özürlülük Değerlendirilmesi Ölçeği) skorlarını değerlendirmeyi amaçladık.
Gereç ve Yöntem: Çalışmaya 120 kronik migren hastası dahil edildi. Hastaların GON blokajı öncesi ve sonrası 1. ve 3. ayda analjezik kullanımı, ağrılı gün sayısı, VAS ve MİDAS skorları değerlendirildi.
Bulgular: GON blokajı uygulanan hastalarda ağrılı gün sayısı, analjezik kullanımı, VAS ve MİDAS skorlarında tedavi öncesi değerlerine göre 1.ve 3. ayda istatiksel olarak anlamlı (p<0,001*) azalma gözlenirken, 1. ve 3. ay bulguları arasında istatiksel olarak anlamlı fark gözlenmedi.
Sonuç: Çalışmamızda medikal tedaviye rağmen günlük yaşam aktivitelerini engelleyen şiddetli baş ağrıları olan hastalarda blokaj uygulanması sonrası baş ağrısında belirgin azalma ve hayat kalitesinde iyileşme dikkati çekmiştir. Tüm çalışmalarda etkin olduğu gösterilmiş, oldukça yüksek faydalanımı olan GON blokajının, migren hastalığı kronikleşmeden ,hastalar fazla medikal yüke maruz kalmadan ve tedavi maliyetleri artmadan tedavi seçeneği haline gelmesi düşünülebilir. 

Keywords

• Baş ağrısı
• kronik migren
• büyük oksipital sinir blokajı

The Efficacy of Greater Occipital Nerve Block in Patients With Chronic Migraine

Abstract

Aim : In chronic migraines(CM), the rate of benefiting from medical treatment is relatively low, and it is known that patients use analgesics extensively. Greater occipital nerve (GON) block, have been started to be used in chronic migraine patients who were refractory to treatment. In this study, we aimed to evaluate the headache attack frequency, analgesic use, VAS (Visual Analog Scale) and MIDAS (Migraine Disability Assessment Scale) scores in the 3-month follow-up of patients we had performed a GON block in our clinic for chronic migraine refractory to medical treatment. Materials and Methods: A total of 120 CM patients were included in the study. The number of analgesics used, the number of days with pain, and the VAS and MIDAS scores were recorded before the GON block and at one and three months of treatment. Results: There was a statistically significant (p<0.001*) reduction in the number of days with pain, analgesic use, and the VAS and MIDAS scores in the first and third months compared to the pre-treatment baseline values in patients who had undergone a GON block. No significant differences between the first and third months. Conclusion: After the GON block, we noted a significant reduction of headaches and improved quality of life in patients who had been experiencing severe headaches despite medical treatment. The GON block has an exceptionally high benefit rate, might be considered as a treatment option before migraines gain chronicity, patients are not exposed to an excessive medical burden and increased treatment costs.

Keywords

• Headache
• Chronic Migraine
• Greater Occipital Nerve Block

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