Key clinical point: Greater occipital nerve (GON) blockade with local anesthetics reduced the severity and duration of headaches in patients with episodic migraine without aura, with the headache frequency reducing significantly among patients receiving lidocaine alone or in combination with triamcinolone.
Major finding: GON block with triamcinolone, lidocaine, lidocaine+triamcinolone, or only normal saline significantly reduced the severity ( P < .001) and duration ( P = .001) of headaches, with no injection being superior to placebo. Headache frequency reduced in patients who received lidocaine (5.81 attacks per month; 95% CI of the difference −2.52 to −9.09) and lidocaine+triamcinolone (5.69 attacks per month; 95% CI of the difference −1.11 to −10.27).
Study details: This placebo-controlled clinical trial randomly assigned 55 adult patients with episodic migraine without aura to triamcinolone (n = 10), lidocaine (n = 16), lidocaine+triamcinolone (n = 13), or normal saline only (n = 16) groups.
Disclosures: This work was supported by the Iranian Center of Neurological Research in affiliation with Tehran University of Medical Sciences. The authors declared no conflict of interests.
Source: Malekian N et al. Cephalalgia. 2021 (Nov 17). Doi: 10.1177/03331024211058182.