Intranasal Lidocaine for Primary Headache Management in Emergency Department; a Clinical Trial
Archives of Academic Emergency Medicine,
Vol. 5 No. 1 (2017),
1 January 2017
,
Page e79
https://doi.org/10.22037/aaem.v5i1.204
Abstract
Introduction: Most of the headache cases only require pain management in emergency department (ED). The present study aimed to evaluate the efficacy of intranasal lidocaine in this regard. Method: In this clinical trial, adult patients with primary headache were randomly treated with 7.5 mg intravenous (IV) chlorpromazine and 1 ml intranasal lidocaine 2% (treatment) or normal saline 0.9% (placebo), and were compared 5, 15, and 30 minutes later regarding success rate using SPSS 21. Result: 100 patients were assigned to either treatment or placebo group. Number needed to treat of intranasal lidocaine at 5, 15, and 30 minutes were 4 (95% CI: 2.2 – 6.6), 3 (95% CI: 1.7 – 3.5), and 4 (95% CI: 2.3 – 15.9), respectively. These measures for absolute risk reduction were 30 (95% CI: 15.2 – 44.8), 44 (95% CI: 28.7 – 59.3), and 26 percent (95% CI: 6.3 – 44.3), respectively. Pain relapse occurred in 16% of treatment and 11% of control group within 1 hour of treatment (p = 0.402). Conclusion: It seems that, intranasal lidocaine along with IV chlorpromazine could result in more successful and faster management of primary headaches in ED.- Pain management
- tension-type Headache
- administration
- intranasal
- lidocaine
- migraine disorders
How to Cite
References
Go S. Nontraumatic headaches in the Emergency Department: a systematic approach to diagnosis and controversies in two" big ticket" entities. Missouri medicine. 2008;106(2):156-61.
Edvinsson L. Pathophysiology of primary headaches. Current pain and headache reports. 2001;5(1):71-8.
Rapoport AM, Bigal ME, Tepper SJ, Sheftell FD. Intranasal medications for the treatment of migraine and cluster headache. CNS drugs. 2004;18(10):671-85.
Van Vliet J, Bahra A, Martin V, Ramadan N, Aurora S, Mathew N, et al. Intranasal sumatriptan in cluster headache Randomized placebo-controlled double-blind study. Neurology. 2003;60(4):630-3.
Cittadini E, May A, Straube A, Evers S, Bussone G, Goadsby PJ. Effectiveness of intranasal zolmitriptan in acute cluster headache: a randomized, placebo-controlled, double-blind crossover study. Archives of neurology. 2006;63(11):1537-42.
Diamond S, Freitag F, Phillips S, Bernstein J, Saper J. Intranasal Civamide for the Acute Treatment of Migraine Headache. Cephalalgia. 2000;20(6):597-602.
Costa A, Pucci E, Antonaci F, Sances G, Granella F, Broich G, et al. The effect of intranasal cocaine and lidocaine on nitroglycerinâ€induced attacks in cluster headache. Cephalalgia. 2000;20(2):85-91.
Robbins L. Intranasal Lidocaine for Cluster Headache. Headache: The Journal of Head and Face Pain. 1995;35(2):83-4.
Mohammadkarimi N, Jafari M, Mellat A, Kazemi E, Shirali A. Evaluation of efficacy of intra-nasal lidocaine for headache relief in patients refer to emergency department. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences. 2014;19(4):331.
Generali J, Cada DJ. Intranasal lidocaine: Migraine headaches. Hospital Pharmacy. 2001;36(2):192-223.
Blanda M, Rench T, Gerson LW, Weigand JV. Intranasal lidocaine for the treatment of migraine headache: a randomized, controlled trial. Academic Emergency Medicine. 2001;8(4):337-42.
Maizels M, Geiger AM. Intranasal lidocaine for migraine: a randomized trial and openâ€label followâ€up. Headache: The Journal of Head and Face Pain. 1999;39(8):543-51.
Djupesland PG, Messina JC, Mahmoud RA. Breath Powered Nasal Delivery: A New Route to Rapid Headache Relief. Headache: The Journal of Head and Face Pain. 2013;53:72-84.
- Abstract Viewed: 442 times
- PDF Downloaded: 190 times
- HTML Downloaded: 54 times
Download Statastics
Make a Submission
SJR
COPE
