The Efficiency of Peripheral Nerve Blockade and Trigger Point Injections In The Treatment of Chronic Tension-Type Headache

Mustafa Ceylan; Ahmet Yalçın

EN TR

The Efficiency of Peripheral Nerve Blockade and Trigger Point Injections In The Treatment of Chronic Tension-Type Headache

Abstract

Purpose: Greater and lesser occipital nerve blockade GONB/LONB using local anesthetics with and without corticosteroids, and supraorbital and supratrochlear nerve blockade STNB using local anesthetics and trigger point injections TPI are commonly employed for the treatment of primary and secondary headache disorders. In this study, we aimed to investigate the efficiency of peripheral nerve blockade in the treatment of chronic tension-type headache.Patients and Methods: A total of 174 patients who received GONB and/or STNB with or without TPI between June 2013 and October 2016 were included in this study. The patients were divided into three groups as GONB, GONB+STNB, GONB+STNB+TPI and followed up for four weeks with VAS score. In the GONB alone group, triamcinolone and bupivacaine were used, and in the remaining two groups, only bupivacaine was administered. Results: The mean age of the study population was 43.2±7.2 years. Female dominance was present. There were no statistically significant differences between the three groups regarding age and gender. Furthermore, headache frequency and VAS scores of the groups did not significantly differ before treatment; however, significant differences were observed in both between and within groups after treatment. The response rates were significantly higher 50% and 75% in the last treatment group.Conclusion: In this study, TPI combined with GONB and STNB was superior to GONB+STNB and GONB alone regarding headache frequency. We also found that in all groups, post-treatment VAS scores and headache frequency were lower compared to pretreatment values

Keywords

Chronic tension-type headache,Peripheral nerve blockade,Greater Occipital Nerve Block,Supratrochlear Nerve Block

KRONİK GERİLİM TİPİ BAŞ AĞRISI TEDAVİSİNDE PERİFERİK SİNİR BLOKAJI VE TETİK NOKTA ENJEKSIYONLARININ ETKİNLİĞİ

Öz

Amaç: Lokal anestezik madde tek başına veya kortikosteroid ile kombine yapılan büyük veya küçük oksipital sinir blokajları GONB/LONB , lokal anestezik madde ile yapılan supraorbital sinir blokajı SONB veya supratroklear sinir blokajları STNB gibi periferik sinir blokajı uygulamaları ve tetik nokta enjeksiyonları TPI primer veya sekonder baş ağrıları tedavilerinde kullanılabilir. Çalışmamızda bu uygulamaların kronik gerilim tipi baş ağrısında etkinliğini araştırmayı amaçladık.Hastalar ve Yöntemler: Haziran 2013 ile Ekim 2016 tarihleri arasında kronik gerilim tipi baş ağrısı tanısıyla GONB, STNB ve TPI yapılan 174 hasta belirlenen gruplara ayrıldı ve enjeksiyonun 4 hafta öncesi ve 4 hafta sonrası takiplerinde VAS ve ağrı frekansları retrospektif karşılaştırıldı. Birinci grup sadece GONB, ikinci grup GONB+STNB ve üçüncü grup aynı anda üç uygulamanında yapıldığı hastalardan oluşturuldu. GONB bupivakain ve triamsinalon ile diğer uygulamalar bupivakain ile yapıldı. Bulgular: Hastaların yaş ortalaması 43.2±7.2, kadın cinsiyet biraz daha fazla tespit edildi. Her üç grup arasında cinsiyet ve yaş ortalamaları arasında istatistiksel fark tespit edilmedi. Gruplar arasında tedavi öncesi ağrı sıklığı ve VAS değerleri arasında istatistiksel fark yok iken, tedavi sonrası bu parametreler arasında grupların kendi içinde ve arasında anlamlı fark tespit edildi. Grup üçte %50 ve %75 yanıt oranlarında anlamlı farklılık tespit edildi.Sonuç: Çalışmada, STNB + GONB ile TPI’nin frekans açısından tek başına STNB+ GONB kombinasyonu veya GONB’ye kıyasla daha iyi sonuçlar verdiğini tespit ettik. Ayrıca tanımlanan tüm enjeksiyon yöntemlerinin etkili olduğunu ve tedaviden sonra VAS skorunu ve baş ağrısı sıklığını azalttığını tespit ettik

Anahtar Kelimeler

Kronik gerilim tipi baş ağrısı, Periferik Sinir Blokajı, Büyük Oksipital Sinir Blokajı, Supratkroklear Sinir Blokajı, Tetik Nokta Enjeksiyonu

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Details

Primary Language

English

Subjects

-

Journal Section

-

Authors

Mustafa Ceylan

Ahmet Yalçın

Publication Date

June 1, 2020

Submission Date

-

Acceptance Date

-

Published in Issue

Year 2020 Number: 2

IZ

https://izlik.org/JA35GK67WR

Cite

RIS / Bibtex

EndNote

Ceylan M, Yalçın A (June 1, 2020) The Efficiency of Peripheral Nerve Blockade and Trigger Point Injections In The Treatment of Chronic Tension-Type Headache. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 2 304–309.