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Greater occipital nerve (GON) block may be a promising approach to treat migraine. However, the results remained controversial. We conducted a systematic review and meta-analysis to explore the efficacy of GON block in migraine patients.PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the efficacy of GON block versus placebo in migraine patients were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. Meta-analysis was performed using the random-effect model.Six RCTs were included in the meta-analysis. Overall, compared with control intervention in migraine patients, GON block intervention was found to significantly reduce pain score (Std. mean difference = − 0.51; 95% CI = − 0.81 to − 0.21; P = 0.0008), number of headache days (Std. mean difference = − 0.68; 95% CI = − 1.02 to − 0.35; P < 0.0001), and medication consumption (Std. mean difference = − 0.35; 95% CI = − 0.67 to − 0.02; P = 0.04), but demonstrated no influence on duration of headache per four weeks (Std. mean difference = − 0.07; 95% CI = − 0.41 to 0.27; P = 0.70).Compared to control intervention, GON block intervention can significantly alleviate pain, reduce the number of headache days and medication consumption, but have no significant influence on the duration of headache per four weeks for migraine patients.