Greater Occipital Nerve Blockade in Chronic Migraine: Meta-Analysis
Abstract
Chronic migraine significantly impacts quality of life and remains a therapeutic challenge, with many patients experiencing limited relief from traditional treatments. Greater occipital nerve (GON) blockade has emerged as a potential intervention, utilizing bupivacaine to alleviate migraine frequency and severity. This meta-analysis assesses the efficacy of GON blockade in reducing headache days per month in patients with chronic migraine. A meta-analysis was conducted, encompassing four randomized, placebo-controlled studies published between 2014 and 2024. The studies included a total of 202 participants (105 in the intervention group and 97 in the placebo group) who received GON blockade with bupivacaine or a placebo. The primary outcome measured was the mean difference in monthly headache days between the intervention and placebo groups. Statistical heterogeneity across studies was also assessed. The pooled analysis revealed a statistically significant reduction in monthly headache days in the GON blockade group compared to placebo, with an average difference of -5.7 days (95% CI: -8.5 to -2.9; p < 0.0001). Individual studies demonstrated consistent reductions in headache days in the intervention group, with mean differences ranging from -1.1 to -12.8 days. Heterogeneity was moderate (I² = 30.3%), indicating some variability across studies but an overall trend favoring the intervention. This meta-analysis supports the efficacy of GON blockade with bupivacaine as a…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 202 participants or records.
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