Peripheral Nerve Blocks OK for Migraines in Pregnancy
(HealthDay News) — For migraines that do not respond to medications, peripheral nerve blocks may be a treatment option in pregnant women, according to research published online November 5 in Obstetrics & Gynecology.
Shravya Govindappagari, MD, from the Albert Einstein College of Medicine in Bronx, NY, and colleagues retrospectively reviewed the charts of all pregnant patients (mean age, 28 years; mean gestational age, 23.5 weeks) treated with peripheral nerve blocks for migraine over a five-year period.
The researchers found that peripheral nerve blocks were performed 27 times in 13 pregnant women either in a single (six women) or multiple (seven women) injection series. More than one-third (38.5%) of women had chronic migraine. Peripheral nerve blocks were used for status migrainosus (51.8%) or short-term prophylaxis of frequent headache attacks (48.1%). Oral medications failed for all patients and intravenous medications failed for most before peripheral nerve blocks were performed. For those with status migrainosus, average pain reduction was significant immediately post-procedure (P<0.001) and 24 hours post-procedure (P=0.007). There were no serious immediate, procedurally-related adverse events; however, two patients who had no acute pain reduction ultimately developed preeclampsia and had postpartum headache resolution.
"Peripheral nerve blocks for treatment-refractory migraine may be an effective therapeutic option in pregnancy," the authors write.
One author disclosed financial ties to the pharmaceutical industry.