
Researchers from the University of Pennsylvania in Philadelphia studied the effectiveness of bilateral blockade of the greater occipital nerves with a 2% lidocaine solution in children with severe refractory migraine attacks.
The study included 58 children and adolescents with acute migrainous status. The average age was 16 years, with 44 female participants and 14 male participants. Participants experienced migraine episodes lasting 22 days and were unresponsive to other treatment methods.
As an introductory phase, all participants were applied a lidocaine cream for 30 minutes, and they could opt out of injections if they deemed the effect sufficient. This phase led to a slight reduction in overall pain scores (0.2 points on a scale of 0 to 10). Therefore, all participants underwent randomized, double-blind injections into the greater occipital nerve with a 2% lidocaine solution or saline solution.
Researchers found that children who received lidocaine injections experienced significantly greater pain relief than peers who received saline injections:
- Within 30 minutes, the average reduction in pain intensity was 2.3 points (on a scale of 0 to 10) compared to a reduction of 1.1 points when using saline solution.
- Pain reduction of 2 points was achieved in 69% of patients in the lidocaine group compared to 34% in the saline group.
- Approximately 76% of patients receiving lidocaine reported partial relief of pain severity or localization compared to 48% of patients receiving saline solution.
Interestingly, patients rated the saline injection as more painful than the lidocaine injection.
Further research is needed, but based on current results, lidocaine injections may become a valuable tool for treating treatment-resistant migraine in adolescents and young people.