# Combination effect of ultrasound-guided superior cervical ganglion block and standard triptan for migraine attacks

## TL;DR

Combining ultrasound-guided cervical ganglion block with standard migraine medication provides better headache relief and improved quality of life for acute migraine patients.

## Contribution

Demonstrates the added benefit of ultrasound-guided SCG block when used with triptans for acute migraine treatment.

## Key findings

- Combining SCG block with triptans improved headache relief by 21.7% compared to triptans alone.
- Patients with SCG block showed greater improvement in migraine-related disability and quality of life.
- No major adverse events were observed in the SCG block group.

## Abstract

Background: To examine whether the combination of
ultrasound (US)-guided superior cervical ganglion (SCG) block with standard
triptans has a superior relief of headache as compared to triptans alone for
acute migraine. Methods: The retrospective-prospective
cohort study enrolled patients presenting with acute migraine.
The records of 243 cases receiving standard triptans and an adjunctive US-guided
SCG were reviewed, while 230 cases were prospectively enrolled to receive triptan
alone for control after age and sex matching in a 1:1.2 ratio. The primary
endpoint was sustained headache relief and complete freedom
from pain within post-procedural 24 hours. Secondary outcomes
included headache relief and freedom from pain at 2 hours,
monthly migraine days (MMDs), migraine disability assessment
(MIDAS) scores, migraine-specific quality of life questionnaire (MSQ) scores,
need for rescue analgesics use and adverse events. Results: Sustained
headache relief was observed in 69.5% of cases in the SCG cohort, yielding a
superior outcome increased by 21.7% (95% confidence interval (CI): 13.1%,
30.4%) (p < 0.001). Overall, SCG block plus triptans had a better
effect on headache relief and freedom from pain at post-procedural 2 hours, and
sustained freedom from headache within 24 hours compared to triptans alone. At
1-month visit, SCG cohort also showed a greater improvement in MMDs (p
< 0.01), MIDAS scores (p = 0.040) and MSQ scores (p = 0.036).
No major adverse events were observed. Conclusions:
There was a superior therapeutic effectiveness of US-guided SCG block in
conjunction with standard triptans for better headache relief
up to post-procedural 1 month in acute
migraine. It had an adjunctive beneficial
effect in functional ability, life quality and possible facilitation of avoiding
more adverse events.