Comparative Efficacy of Greater Occipital Nerve Blockade and Sphenopalatine Ganglion Blockade in Patients with Episodic Migraine: A Randomized Trial | ||
| Egyptian Journal of Anaesthesia | ||
| Volume 41, Issue 1, 2025, Pages 1-6 PDF (406.93 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/egja.2025.393058.1122 | ||
| Authors | ||
| Ahmed Omar Mahmoud* 1; Adel Alqarni2; Ahmed Abdelkader Ahmed3; Mahmoud Alhasan Mohamed Hasan4; mostafa Hassanien bakr4 | ||
| 1Anesthesia and Intensive Care and Pain Management Department, Faculty of Medicine, New Valley University, New Valley, Egypt. | ||
| 2Anesthesia and Intensive Care and Pain Management Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia. | ||
| 3Anesthesia and Intensive Care and Pain Management Department, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia. | ||
| 4Anesthesia and Intensive Care and Pain Management Department, Faculty of Medicine, Assiut University, Assiut, Egypt. | ||
| Abstract | ||
| Background: Episodic migraine significantly impairs quality of life, and some cases fail to respond to conventional prophylactic treatments. Alternative therapy approaches are provided by interventional nerve blocks, such as sphenopalatine ganglion (SPG) and greater occipital nerve (GON) blockades. This work compared the effectiveness of GON blockade and SPG blockade in reducing headache intensity, duration, frequency, and disability in cases with episodic migraine. Methods: This study was prospective, randomized, controlled, and single-blind and was conducted on 60 cases, both sexes, aged 18-65 years, diagnosed with episodic migraine per the international classification of headache disorders, 3rd edition criteria, and failed to achieve adequate relief with at least one prophylactic migraine treatment. Cases were randomly assigned into two groups to receive either the GON blockade in the GON group or the SPG blockade in the SPG group. Blocks were performed using 2 mL of 2% lidocaine. Results: Intensity, migraine disability assessment scores, and number of NSAIDs per day were significantly lower at 1, 2, and 3m in the GON Group as opposed to the SPG Group (P < 0.05). Migraine duration and the reduction in the number of NSAIDs per day were notably increased in the GON Group in contrast to the SGP Block Group (P< 0.05). Adverse events (nasal irritation, temporary difficulty in swallowing, vasovagal reaction) and patient satisfaction were comparable. Conclusions: GON blockade is a superior short-term intervention for cases unresponsive to standard prophylactic therapy, offering greater reductions in headache intensity, frequency, and disability as opposed to SPG blockade. | ||
| Keywords | ||
| Episodic Migraine; Headache Intensity; Occipital Nerve; Pain Management; Sphenopalatine Ganglion | ||
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