Comparison of the Efficacy of Ultrasound-guided Greater Occipital Nerve Block and Pulsed Radiofrequency Therapy in Chronic Migraine Patients
Condition: Chronic Migraine, Headache
MeSH terms: Migraine Disorders; Headache
Study type: Interventional

Summary: 
      Chronic migraine (CM) is related to headache-related disability and reduced quality of life.
      Therefore, patients with CM require preventive treatment. The aim of this double-blind,
      comparative-effectiveness study was to compare ultrasound-guided great occipital nerve (GON)
      block and pulsed radiofrequency (PRF) application in CM patients.

      The study consisted of 2 groups: GON block (group GONB) and GON block + pulsed RF (group
      GONB+PRF). Each group had 16 patients. Ultrasound-guided GONB was performed to locate the
      nerve more accurately. With 0.5 Hz sensorial stimulation, a 5-cm-long radiofrequency needle
      was advanced under ultrasound guidance in both groups. GON block was performed in all
      patients by administering 5mg bupivacaine through a PRF needle. After the GON block, the PRF
      neuromodulation was applied at 42 degrees for 4 minutes in the GONB-PRF group. In the GONB
      group, no pulse was given. The patients were examined for follow-ups at the 1st, 2nd, 3rd,
      and 6th months after the procedure. The severity and the number of migraine attacks, and the
      number of analgesic drugs were noted.
    


Intervention name(s): USG Guided Greater Occipital Nerve Block; USG Guided Greater Occipital Nerve Block and Pulsed Radiofrequency
Intervention type(s): Procedure; Procedure
Intervention description(s): With 0.5 Hz sensorial stimulation, a 5-cm-long radiofrequency needle with a 0.5 cm active tip was advanced under ultrasound guidance in both pulsed PRF and nerve block groups. USG probe was located to medial one-third of the superior nuchal line between the occipital tubercle and mastoid process under sterile conditions. Finally, the placement of the needle was verified by Doppler imaging of the occipital artery. A 0.3-0.5 Hz sensory stimulus was given with the RF device, and the paresthesia sensation in the patient's occipital nerve dermatome was questioned, and location verification was performed. Then, GON block was performed in all patients by administering 5mg bupivacaine through a PRF needle. After the GON block, the PRF neuromodulation was applied at 42 degrees for 4 minutes in the GONB-PRF group. In the GONB group, the PRF generator was set for 4 minutes, and the time was waited, but no pulse was given.; With 0.5 Hz sensorial stimulation, a 5-cm-long radiofrequency needle with a 0.5 cm active tip was advanced under ultrasound guidance in both pulsed PRF and nerve block groups. USG probe was located to medial one-third of the superior nuchal line between the occipital tubercle and mastoid process under sterile conditions. Finally, the placement of the needle was verified by Doppler imaging of the occipital artery. A 0.3-0.5 Hz sensory stimulus was given with the RF device, and the paresthesia sensation in the patient's occipital nerve dermatome was questioned, and location verification was performed. Then, GON block was performed in all patients by administering 5mg bupivacaine through a PRF needle. After the GON block, the PRF neuromodulation was applied at 42 degrees for 4 minutes in the GONB-PRF group. In the GONB group, the PRF generator was set for 4 minutes, and the time was waited, but no pulse was given.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment