PMID- 37314033
OWN - NLM
STAT- MEDLINE
DCOM- 20230621
LR  - 20230904
IS  - 1526-4610 (Electronic)
IS  - 0017-8748 (Linking)
VI  - 63
IP  - 6
DP  - 2023 Jun
TI  - Ultrasound-guided stellate ganglion block for the treatment of migraine in 
      elderly patients: A retrospective and observational study.
PG  - 763-770
LID - 10.1111/head.14537 [doi]
AB  - OBJECTIVES: This study aimed to assess the effectiveness and safety of 
      ultrasound-guided stellate ganglion block (SGB) in the prophylactic treatment of 
      migraine in the elderly. BACKGROUND: Treatment of migraine in the elderly is 
      often difficult and troublesome due to multiple comorbidities, drug interactions, 
      and adverse effects (AEs). SGB may be an effective treatment approach for 
      migraine in the elderly as its clinical use is rarely limited by concomitant 
      diseases and age-related physiological changes; however, no studies have 
      evaluated the effectiveness of SGB in the treatment of migraine in the elderly 
      population. METHODS: This is a retrospective observational case series study. We 
      retrospectively analyzed patients with migraine aged >/=65 years, who underwent 
      ultrasound-guided SGB for headache management between January 2018 and November 
      2022. Pain intensity using the numerical rating scale (NRS, 0-10), number of days 
      with headache per month, duration of headache, and the consumptions of acute 
      medications were recorded before SGB treatment, and at 1, 2, and 3 months after 
      the last SGB. Safety assessment included thorough documentation of serious and 
      minor AEs related to SGB. RESULTS: Of 71 patients, 52 were analyzed in this 
      study. After the final SGB, the NRS scores decreased significantly from a mean 
      (+/- standard deviation [SD]) of 7.3 (1.2) at baseline to 3.3 (1.4), 3.1 (1.6), and 
      3.6 (1.6) at 1, 2, and 3 months, respectively (vs. baseline, p < 0.001). The mean 
      (SD) number of headache days per month significantly reduced from 23.1 (5.5) to 
      10.9 (7.1) (p < 0.001), 12.7 (6.5) (p = 0.001), and 14.0 (6.8) days (p = 0.001) 
      at the 1-, 2-, and 3-month follow-ups, respectively. The values of headache 
      duration were also significantly lower at the 1-month (mean [SD] 12.5 [15.8] h, 
      p = 0.001), 2-month (mean [SD] 11.3 [15.9] h, p = 0.001), and 3-month follow-ups 
      (mean [SD] 14.3 [16.0] h, p = 0.001) compared to pre-treatment baseline (mean 
      [SD] 22.7 [17.1] h). There were 33/52 (64%) patients experiencing at least a 50% 
      reduction in acute medications consumption 3 months after the final SGB 
      treatment. The overall AEs rate associated with ultrasound-guided SGB was 9.0% 
      (26/290 SGBs). There were no serious AEs; all reported AEs were minor and 
      transient. CONCLUSIONS: Stellate ganglion block treatment could reduce pain 
      intensity, headache frequency, and duration of migraine, thereby reducing the 
      need for adjunctive medications in elderly patients. Ultrasound-guided SGB might 
      be a safe and effective intervention for the treatment of migraine in elderly 
      patients.
CI  - (c) 2023 American Headache Society.
FAU - Yu, Bin
AU  - Yu B
AD  - Department of Day Surgery, Beijing Tiantan Hospital, Capital Medical University, 
      Beijing, China.
FAU - Hou, Siyu
AU  - Hou S
AD  - Department of Education, Fuxing Hospital, Capital Medical University, Beijing, 
      China.
FAU - Xing, Yan
AU  - Xing Y
AD  - Department of Day Surgery, Beijing Tiantan Hospital, Capital Medical University, 
      Beijing, China.
FAU - Jia, Zipu
AU  - Jia Z
AD  - Department of Day Surgery, Beijing Tiantan Hospital, Capital Medical University, 
      Beijing, China.
FAU - Luo, Fang
AU  - Luo F
AUID- ORCID: 0000-0002-3584-0355
AD  - Department of Day Surgery and Pain Management, Beijing Tiantan Hospital, Capital 
      Medical University, Beijing, China.
LA  - eng
PT  - Comment
PT  - Journal Article
PT  - Observational Study
DEP - 20230614
PL  - United States
TA  - Headache
JT  - Headache
JID - 2985091R
SB  - IM
CON - Medicine (Baltimore). 2020 May;99(18):e20023. PMID: 32358380
MH  - Humans
MH  - Aged
MH  - Retrospective Studies
MH  - Stellate Ganglion/diagnostic imaging
MH  - *Migraine Disorders/diagnostic imaging/therapy/complications
MH  - *Autonomic Nerve Block
MH  - Headache/complications
MH  - Ultrasonography, Interventional
OTO - NOTNLM
OT  - effectiveness
OT  - elderly
OT  - migraine
OT  - retrospective study
OT  - stellate ganglion block
EDAT- 2023/06/14 13:07
MHDA- 2023/06/21 06:42
CRDT- 2023/06/14 07:13
PHST- 2023/04/25 00:00 [revised]
PHST- 2023/03/08 00:00 [received]
PHST- 2023/04/28 00:00 [accepted]
PHST- 2023/06/21 06:42 [medline]
PHST- 2023/06/14 13:07 [pubmed]
PHST- 2023/06/14 07:13 [entrez]
AID - 10.1111/head.14537 [doi]
PST - ppublish
SO  - Headache. 2023 Jun;63(6):763-770. doi: 10.1111/head.14537. Epub 2023 Jun 14.