Comparison of Greater Occipital Nerve and Supra Orbital Nerve Blocks Methods in the Treatment of Acute Migraine Attack: A randomized double-blind controlled trial

The aim of this study was to investigate central anti-nociceptive mechanisms of i.v. acetylsalicylic acid (ASA) and oral zolmitriptan (ZOL) in migraine patients and healthy subjects using the ‘nociceptive’ blink reflex (nBR). Twenty-eight migraine patients received ASA ( n = 14, 1000 mg i.v) or ZOL ( n = 14, 5 mg p.o) during the acute migraine attack and interictally. Thirty healthy subjects received either ASA or ZOL vs. placebo using a double blind cross over design. nBR was recorded in all patients and subjects before, 60 and 90 min after treatment. ASA and ZOL did not inhibit nBR responses in healthy subjects. Both ASA and ZOL suppressed nBR responses (ASA by 68%, ZOL by 78%) only during the acute attack but not interictally. The data suggest, that the anti-nociceptive effects of migraine drugs on the trigeminal nociceptive processing are different during and outside an acute migraine attack.

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Treatment of Acute Migraine Attack: Naproxen and Placebo Compared

Cephalalgia ◽

10.1046/j.1468-2982.1985.0502115.x ◽

1985 ◽

Vol 5 (2) ◽

pp. 115-119 ◽

Cited By ~ 39

Author(s):

Knut Nestvold ◽

Reidar Kloster ◽

Markku Partinen ◽

Raimo Sulkava

Keyword(s):

Migraine Attack ◽

Randomized Study ◽

Treatment Preferences ◽

Acute Migraine ◽

Treatment Results ◽

Double Blind ◽

Head Pain ◽

Main Complaint ◽

Gastrointestinal Discomfort ◽

Acute Migraine Attack

A double-blind, cross-over, randomized study of acute migraine attack compared treatment results of naproxen with that of placebo. Each treatment period continued for either three months or six migraine attacks, whichever occurred first. The initial dose of naproxen was 750 mg, with additional 250–500 mg doses taken if and when required, to a maximum of five 250 mg tablets within a period of 24 h in each migraine attack. Forty-one patients were enrolled in the study; they had all experienced at least two but not more than eight migraine attacks a month during the preceding year. Thirty-two patients completed the two treatment periods. Naproxen was statistically significantly superior to placebo in reducing the severity of head pain, nausea, and photophobia; in shortening the duration of head pain, nausea, vomiting, photophobia, and lightheadedness; in diminishing the frequency of vomiting; and in decreasing the need for escape medication. Both patient and physician treatment preferences significantly favoured naproxen. Nine side effects were experienced by seven patients while receiving placebo and seven by five patients during naproxen treatment. Mild gastrointestinal discomfort was the main complaint. Only one patient withdrew from treatment because of a side effect, which occurred while receiving placebo.

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Double-Blind Comparison of An Acetaminophen 400 mg-Codeine 25 mg Combination Versus Aspirin 1000 mg and Placebo in Acute Migraine Attack

Cephalalgia ◽

10.1046/j.1468-2982.1994.1402156.x ◽

1994 ◽

Vol 14 (2) ◽

pp. 156-161 ◽

Cited By ~ 43

Author(s):

F Boureau ◽

JM Joubert ◽

V Lasserre ◽

B Prum ◽

G Delecoeuillerie

Keyword(s):

Clinical Trials ◽

Migraine Attack ◽

Evaluation Criteria ◽

Complete Disappearance ◽

Acute Migraine ◽

Double Blind ◽

Significant Difference ◽

The Difference ◽

Blind Comparison ◽

Acute Migraine Attack

The purpose of this study was to compare the efficacy and tolerance of a single dose of the acetaminophen 400 mg-codeine 25 mg combination (ACC) aspirin 1000 mg (A) and a placebo (P) for the treatment of acute migraine attack. The study design was randomized, multicentre, double-blind and double dummy with cross-over on three periods. Of the 198 patients who had three attacks 29.8%, 52.3% and 49.7% had recorded the complete or almost complete disappearance of the pain at 2 h after P, A and ACC respectively. When compared with the placebo, the difference was significant for the A and ACC. When complete disappearance of pain at 2 h was used as a criterion, no significant difference was observed. These results enabled the sensitivity of the evaluation criteria suggested for clinical trials of migraine attack to be discussed.

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Efficacy of Acupuncture for Acute Migraine Attack: A Multicenter Single Blinded, Randomized Controlled Trial

Pain Medicine ◽

10.1111/j.1526-4637.2012.01376.x ◽

2012 ◽

Vol 13 (5) ◽

pp. 623-630 ◽

Cited By ~ 32

Author(s):

Lin-Peng Wang ◽

Xiao-Zhe Zhang ◽

Jia Guo ◽

Hui-Lin Liu ◽

Yan Zhang ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Migraine Attack ◽

Controlled Trial ◽

Acute Migraine ◽

Randomized Controlled ◽

Acute Migraine Attack

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Acute migraine attack, angina-like chest pain with documented ST-segment elevation and slow coronary flow

Acta Cardiologica ◽

10.2143/ac.60.2.2005036 ◽

2005 ◽

Vol 60 (2) ◽

pp. 221-223 ◽

Cited By ~ 8

Author(s):

Hüseyin UYAREL ◽

Ismail ERDEN ◽

Nese CAM

Keyword(s):

Chest Pain ◽

Migraine Attack ◽

Coronary Flow ◽

Acute Migraine ◽

Slow Coronary Flow ◽

St Segment Elevation ◽

St Segment ◽

Acute Migraine Attack

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Sphenopalatine Ganglion versus Greater Occipital Nerve Blocks in Treating Post-Dural Puncture Headache after Spinal Anesthesia for Cesarean Section: A Randomized Clinical Trial

January 2018 - Pain Physician ◽

10.36076/ppj.2021.24.e443 ◽

2021 ◽

pp. E443-E451

Keyword(s):

Cesarean Section ◽

Dural Puncture ◽

Sphenopalatine Ganglion ◽

Ganglion Block ◽

Nerve Blocks ◽

Neck Stiffness ◽

Post Dural Puncture Headache ◽

Occipital Nerve ◽

Greater Occipital Nerve ◽

Blood Patch

BACKGROUND: Despite being invasive, with serious complications, epidural blood patch (EBP) is still considered the gold standard therapy for Post Dural Puncture Headache (PDPH). The use of Peripheral nerve blocks for PDPH are studied here. OBJECTIVES: To investigate the efficacy of sphenopalatine ganglion block (SPGB) and greater occipital nerve block (GONB) to relieve PDPH and its associated symptoms. STUDY DESIGN: Randomized comparative single-blind trial. SETTING: A University hospital. METHODS: Patients who received spinal anesthesia for elective cesarean section, and then developed PDPH during hospitalization or within 5 days after dural puncture were enrolled to receive GONB (n = 47) or SPGB (n = 46) for treatment of PDPH. GONB Group: Patients received bilateral GONB using 3 mL mixture of 2 mL lidocaine 2% plus 1 mL dexamethasone 4 mg on each side of occipital region. SPGB Group: Patients received bilateral SPGB using the same mixture in each nostril. Assessments included Numeric Rating Scale (NRS) for severity of headache at supine and sitting positions, nausea NRS, neck stiffness, need for EBP, and complications. RESULTS: The supine and sitting headache NRS scores significantly decreased at 30 minutes after blocks and throughout follow-up period in both groups (P < 0.000). Clinically significant drop of NRS to < 4 was reached earlier in GONB group. There was a significant difference between groups after 2 hours in supine and sitting headache NRS scores (P = 0.020 and 0.030, respectively); however, both treatments showed similar effectiveness from the third hour afterwards (P > 0.05). Both techniques were effective in relieving neck stiffness and nausea (P < 0.000), with no adverse effects. LIMITATIONS: A limitation to this study was the small sample size. CONCLUSIONS: GONB and SPGB are equally effective in relieving symptoms of PDPH. Both techniques are safe, simple, and less invasive than EBP. KEY WORDS: Cesarean Section, epidural blood patch greater occipital nerve block, post-dural puncture headache, sphenopalatine ganglion block

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