Ketorolac versus Magnesium Sulfate in Migraine Headache Pain Management; a Preliminary Study
Archives of Academic Emergency Medicine,
Vol. 5 No. 1 (2017),
1 January 2017
,
Page e2
https://doi.org/10.22037/aaem.v5i1.105
Abstract
Introduction: Migraine is a common cause of emergency department (ED) visits. To date, there is no recommended drug of choice for pain management of these patients. In the present study, we aimed to evaluate the effectiveness of ketorolac and magnesium sulfate in this regard. Methods: This is a cross-sectional study performed on all 18 - 60 year-old patients, visiting two different EDs with complaint of moderate to severe migraine headache. Patients were treated with 30 mg ketorolac in one hospital and 1 gram magnesium sulfate in the other. Pain scores were assessed on arrival, 1 and 2 hours after drugs administration and quality of pain management was compared between two groups using SPSS 22. Results: 70 patients with the mean age of 36.4 ± 11.4 years were enrolled (51.4% male). The two groups were similar regarding baseline characteristics (p > 0.05). The improvement in pain score in magnesium sulfate group was greater than Ketorolac group after both one hour (6 vs 3; p < 0.001) and two hours (7 vs 5; p < 0.001). Conclusion: It seems that both ketorolac and magnesium sulfate are significantly effective in pain control of patients with migraine headache presenting to the emergency department. Magnesium sulfate was superior to ketorolac both one and two hours after drug administration.- Magnesium sulfate
- ketorolac
- migraine disorders
- emergency department
- pain management
How to Cite
References
Láinez MJ, GarcÃa-Casado A, Gascón F. Optimal management of severe nausea and vomiting in migraine: improving patient outcomes. Patient related outcome measures. 2013;4:61.
Baratloo A, Negida A, El Ashal G, Behnaz N. Intravenous Caffeine for the Treatment of Acute Migraine: A Pilot Study. Journal of Caffeine Research. 2015.
Friedman BW, Grosberg BM. Diagnosis and management of the primary headache disorders in the emergency department setting. Emergency medicine clinics of North America. 2009;27(1):71-87.
DeMaagd G. The pharmacological management of migraine, part 2: preventative therapy. Pharmacy and Therapeutics. 2008;33(8):480.
Friedman BW, Kapoor A, Friedman MS, Hochberg ML, Rowe BH. The relative efficacy of meperidine for the treatment of acute migraine: a meta-analysis of randomized controlled trials. Annals of emergency medicine. 2008;52(6):705-13.
Baratloo A, Rouhipour A, Forouzanfar MM, Safari S, Amiri M, Negida A. The Role of Caffeine in Pain Management: A Brief Literature Review. Anesthesiology and Pain Medicine. 2015(Inpress).
Balbin JEB, Nerenberg R, Baratloo A, Friedman BW. Intravenous fluids for migraine: A post-hoc analysis of clinical trial data. The American Journal of Emergency Medicine. 2015.
Gelfand AA, Goadsby PJ. A neurologist’s guide to acute migraine therapy in the emergency room. The Neurohospitalist. 2012;2(2):51-9.
Rowe-Jones JM, Medcalf M, Durham SR, Richards DH, Mackay IS. Functional endoscopic sinus surgery: 5 year follow up and results of a prospective, randomised, stratified, double-blind, placebo controlled study of postoperative fluticasone propionate aqueous nasal spray. Rhinology. 2005;43(1):2-10.
Alimohammadi H, Baratloo A, Abdalvand A, Rouhipour A, Safari S. Effects of Pain Relief on Arterial Blood O2 Saturation. Trauma monthly. 2014;19(1).
Demirkaya Ş, Vural O, Dora B, Topçuoğlu MA. Efficacy of intravenous magnesium sulfate in the treatment of acute migraine attacks. Headache: The Journal of Head and Face Pain. 2001;41(2):171-7.
Bigal M, Bordini C, Tepper S, Speciali J. Intravenous magnesium sulphate in the acute treatment of migraine without aura and migraine with aura. A randomized, double-blind, placebo-controlled study. Cephalalgia. 2002;22(5):345-53.
Taggart E, Doran S, Kokotillo A, Campbell S, Villaâ€Roel C, Rowe BH. Ketorolac in the treatment of acute migraine: a systematic review. Headache: The Journal of Head and Face Pain. 2013;53(2):277-87.
Baratloo A, Amiri M, Forouzanfar MM, Hasani S, Fouda S, Negida A. Efficacy measurement of ketorolac in reducing the severity of headache. Journal of Emergency Practice and Trauma. 2016;2(1):21-4.
Kelly A-M. Migraine: pharmacotherapy in the emergency department. Journal of accident & emergency medicine. 2000;17(4):241-5.
Marmura MJ, Silberstein SD, Schwedt TJ. The acute treatment of migraine in adults: the american headache society evidence assessment of migraine pharmacotherapies. Headache: The Journal of Head and Face Pain. 2015;55(1):3-20.
Orr SL, Aubé M, Becker WJ, Davenport WJ, Dilli E, Dodick D, et al. Canadian Headache Society systematic review and recommendations on the treatment of migraine pain in emergency settings. Cephalalgia. 2014:0333102414535997.
- Abstract Viewed: 371 times
- PDF Downloaded: 191 times
- HTML Downloaded: 44 times
