Midterm Clinical Outcomes of Repetitive Transnasal Sphenopalatine Ganglion Blockade in Chronic Migraine

Selin Balta; Meltem Uyar; Cihat Özgüncü

doi:10.19161/etd.1263664

TR EN

Kronik Migrende Tekrarlayan Transnasal Sfenopalatin Gangliyon Blokajının Orta Dönem Klinik Sonuçları

Öz

Amaç: Kronik migren, yaşam kalitesini olumsuz yönde etkilemektedir ve yüksek oranda özürlülüğe neden olmaktadır. Günümüzde kronik migrenli hastalara yönelik spesifik profilaktik tedavi seçeneklerine gereksinim vardır. Çalışmamızda tekrarlanan transnasal sphenopalatin gangliyon blokajının kronik migrenli hastalardaki baş ağrılı gün sayısı, atak şiddeti, atak sayısı, atak süresi, ilaç kötüye kullanımı ve epizodik migrene dönüşüm üzerindeki sonuçlarını ve tedaviye yanıt oranını değerlendirmeyi amaçladık. Gereç ve Yöntem: Bu çalışma retrospektif dizayndadır. Nöroloji kliniklerince ağrı kliniğine yönlendirilen, en az altı aydır kronik migren tanılı ve profilaktik tedavilere yanıtsız veya profilaktik tedavileri tolere edememiş hastalar değerlendirildi. Çalışmaya haftada bir kez dört seans bilateral transnasal sfenopalatin gangliyon blokajı uygulanmış olan hastalar dahil edildi. Blokaj 30 dakika boyunca 0.5 cc’lik 0.5% bupivakain emdirilmiş swap çubukları ile uygulanmıştı. Bulgular: Çalışmaya 40 hasta dahil edildi. Hastaların birinci, üçüncü, altıncı ve dokuzuncu ay takiplerinde başlangıca göre baş ağrılı gün sayısı, atak şiddeti ve atak sıklığı parametrelerinde istatistiksel olarak anlamlı iyileşme olduğu saptandı (p değerleri <0.001). Başlangıçtaki ilaç suistimalinin dokuzuncu ayda %55 (n = 22)’den %25 (n = 10)’e gerilediği ve bu gerilemenin istatistiksel olarak anlamlı olduğu saptandı (p değerleri <0.001). Dokuzuncu ayda hastaların 14 (35%)’ünün çok düşük frekanslı, 8 (20%)’inin düşük frekanslı 7 (%17.5)’sinin yüksek frekanslı epizodik migrene dönüştüğü saptandı. Hastaların tedaviye yanıt oranı birinci, üçüncü, altıncı ve dokuzuncu aylarda sırasıyla %26, %31, %30 ve %28 idi. Hayati tehlike arz eden veya komorbidite yaratan herhangi bir yan etki saptanmadı. Sonuç: Basit bir uygulama aracı gerektiren ve uygulaması kolay olan Spg blokajı, kronik migren profilaksisinde güvenli bir seçenek olabilir.

Anahtar Kelimeler

Midterm Clinical Outcomes of Repetitive Transnasal Sphenopalatine Ganglion Blockade in Chronic Migraine

Abstract

Aim: Chronic migraine affects quality of life negatively, causing high rates of disabilities. There is a requirement for specific prophylactic treatment options in chronic migraine patients. We aimed to evaluate effects of repetitive transnasal sphenopalatine ganglion blockade (SPG) on headache days, severity and duration of attacks, drug abuse, conversion to episodic migraine, and responses to chronic migraine treatment. Materials and Methods: Diagnosed with chronic migraine for at least six months, patients referred to the algology clinic and unresponsive to prophylactic treatments or not tolerating prophylactic treatments were evaluated in the study with a retrospective design. Patients undergoing four-session bilateral transnasal SPG blockade per week were included. SPG was performed with 0.5 cc 0.5% bupivacaine-impregnated swab sticks for 30 minutes. Results: In first, third, sixth, and ninth month follow-ups of 40 patients included, a statistically significant improvement was found in number of headache days and parameters of attack severity and frequency, compared to baseline values (p<0.001). Baseline drug abuse decreased from 55% (n=22) to 25% (n=10) at month nine, and regression was statistically significant (p<0.001). Of 40 patients, migraine severity was detected to turn into very low frequency in 14 (35%), low frequency in eight (20%), and high-frequency episodic migraines in seven (17.5%) patients at month nine. Patients’ responses were 26, 31, 30, and 28% in first, third, sixth, and ninth months, respectively. No life-threatening or comorbid side effects were detected. Conclusion: Requiring a simple administration tool and easy-to-administer, SPG may be a safe alternative for chronic migraine prophylaxis.

Keywords

Destekleyen Kurum

none

Teşekkür

none.

Kaynakça

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Ayrıntılar

Birincil Dil

İngilizce

Konular

Sağlık Kurumları Yönetimi

Bölüm

Araştırma Makalesi

Yazarlar

Selin Balta ^*
0000-0002-9248-6778
Türkiye

Meltem Uyar
0000-0001-8531-6351
Türkiye

Cihat Özgüncü
0000-0001-7755-9409
Türkiye

Yayımlanma Tarihi

19 Mart 2024

Gönderilme Tarihi

11 Mart 2023

Kabul Tarihi

19 Temmuz 2023

Yayımlandığı Sayı

Yıl 2024 Cilt: 63 Sayı: 1

DOI

https://doi.org/10.19161/etd.1263664

IZ

https://izlik.org/JA32ZA64UU

Kaynak Göster

RIS / Bibtex

Vancouver

1.Selin Balta, Meltem Uyar, Cihat Özgüncü. Midterm Clinical Outcomes of Repetitive Transnasal Sphenopalatine Ganglion Blockade in Chronic Migraine. ETD. 01 Mart 2024;63(1):56-63. doi:10.19161/etd.1263664