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学术急诊医学档案

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  3. 卷 5 编号 1 (2017): Continuous volume
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卷 5 编号 1 (2017)

一月 2017

Intranasal Lidocaine for Primary Headache Management in Emergency Department; a Clinical Trial

  • Hassan Barzegari
  • Hassan Motamed
  • Behrad Ziapour
  • Majid Hajimohammadi
  • Mina Kadkhodazadeh

学术急诊医学档案, 卷 5 编号 1 (2017), 1 一月 2017 , 第 e79 页
https://doi.org/10.22037/aaem.v5i1.204 已出版: 2017-09-16

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摘要

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.
关键词:
  • Pain management
  • tension-type Headache
  • administration
  • intranasal
  • lidocaine
  • migraine disorders
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Barzegari H, Motamed H, Ziapour B, Hajimohammadi M, Kadkhodazadeh M. Intranasal Lidocaine for Primary Headache Management in Emergency Department; a Clinical Trial. Arch Acad Emerg Med [网际网络]. 2017年9月16日 [见引于 2026年7月8日];5(1):e79. 载于: https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/204
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参考

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.

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