A comparison of the clinical efficacy of GON block at the C2 level and GON block at the classical distal occipital level in the treatment of migraine

• Published in: Clinical neurology and neurosurgery Vol. 215; p. 107190
• Main Authors: Karaoğlan, Mustafa, İnan, Levent Ertuğrul
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.04.2022; Elsevier Limited
• Subjects: Analgesics; Analgesics - therapeutic use; Anesthetics, Local - therapeutic use; Bupivacaine; Distal occipital GON block; GON block at the C2 level; Greater occipital nerve block; Headache; Headache - drug therapy; Headaches; Humans; Migraine; Migraine Disorders - drug therapy; Nerve Block; Pain; Patients; Retrospective Studies; Treatment Outcome; Ultrasound guided GON block; Distal occipital GON block; Ultrasound guided GON block; Migraine; GON block at the C2 level; Greater occipital nerve block
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2022.107190

The aim of this retrospective study was to compare the efficacy and complications of ultrasound-guided block (C2GON) at the level of C2 and block performed from the distal occiput level (DOGON) as the greater occipital nerve progresses superficially to the obliquus capitis inferior muscle in migraine patients. 63 patients were included in this retrospective study. For C2GON blockade, 2 units of 4 ml 0.5% bupivacaine were prepared for bilateral administration to 32 patients. For DOGON, two 1.5 ml 0.5% bupivacaine was prepared bilaterally for each patient. The patients were evaluated in terms of pain intensity and frequency, analgesic use, and any side effects before the injection and at the 1st and 3rd months after the last treatment. When we compared C2GON block and DOGON block in our study, we found that both blocks were effective for 3 months. The reduction rates in the C2GON and DOGON groups were 75.3% and 59% in the number of severe attacks, 63.9% and 59.1% in the total analgesic use, 71.1% and 56.25% in the triptan use, 78% and 60% in the number of days with severe headache, 63.4% and 50.3% in the duration of headache. The decrease in the highest VAS score was 48.1% in the group with C2GON, while it was 53% in the group with DOGON. Current findings have shown that both C2GON and DOGON blockades are effective in the treatment of migraine for 3 months.