Low-dose propofol for the abortive treatment of pediatric migraine in the emergency department

David C. Sheridan, David M. Spiro, Thuan Nguyen, Thomas K. Koch, Garth D. Meckler

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

OBJECTIVE: Limited progress has been made in the past decade for abortive treatment of migraine headache in the pediatric emergency department (PED). Propofol, a general anesthetic, has been reported to be effective in the treatment of refractory headaches in adults at subanesthetic doses but never in the pediatric population. The goal of this study was to review our institution's experience with subanesthetic doses of propofol for the abortive treatment of pediatric migraine and compare propofol with standard abortive therapy in the PED. METHODS: Retrospective review of all patients discharged from the Oregon Health and Science University PED with a diagnosis of migraine headache from January 2010 to July 2011. Patients treated with subanesthetic doses of propofol were compared with matched controls who received standard abortive migraine therapy, defined as the combined use of a nonsteroidal anti-inflammatory medication, diphenhydramine, and prochlorperazine. Outcome variables of interest included reduction of pain as measured on a self-reported visual analog scale and length of stay after administration of initial abortive medication. RESULTS: Patients who received subanesthetic doses of propofol achieved significantly greater reduction in pain scores (80.1% vs 61.1%; P <0.05) compared with matched controls as well as shorter stay (122 minutes vs 203 minutes; P = 0.2) after treatment. No adverse effects (hypotension, respiratory depression, or hypoxia) were recorded in either group. CONCLUSIONS: Propofol seems to be effective for the abortive treatment of pediatric migraine headache in the PED. Further prospective trials are warranted to either support or refute these initial findings.

Original languageEnglish (US)
Pages (from-to)1293-1296
Number of pages4
JournalPediatric Emergency Care
Volume28
Issue number12
DOIs
StatePublished - Dec 2012
Externally publishedYes

Fingerprint

Propofol
Migraine Disorders
Hospital Emergency Service
Pediatrics
Therapeutics
Prochlorperazine
Diphenhydramine
Pain
General Anesthetics
Visual Analog Scale
Respiratory Insufficiency
Hypotension
Headache
Length of Stay
Anti-Inflammatory Agents
Health
Population

Keywords

  • abortive
  • headache
  • migraine
  • propofol

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Emergency Medicine

Cite this

Low-dose propofol for the abortive treatment of pediatric migraine in the emergency department. / Sheridan, David C.; Spiro, David M.; Nguyen, Thuan; Koch, Thomas K.; Meckler, Garth D.

In: Pediatric Emergency Care, Vol. 28, No. 12, 12.2012, p. 1293-1296.

Research output: Contribution to journalArticle

Sheridan, David C. ; Spiro, David M. ; Nguyen, Thuan ; Koch, Thomas K. ; Meckler, Garth D. / Low-dose propofol for the abortive treatment of pediatric migraine in the emergency department. In: Pediatric Emergency Care. 2012 ; Vol. 28, No. 12. pp. 1293-1296.
@article{3ec60106450a4db5ab22805c2641bdf6,
title = "Low-dose propofol for the abortive treatment of pediatric migraine in the emergency department",
abstract = "OBJECTIVE: Limited progress has been made in the past decade for abortive treatment of migraine headache in the pediatric emergency department (PED). Propofol, a general anesthetic, has been reported to be effective in the treatment of refractory headaches in adults at subanesthetic doses but never in the pediatric population. The goal of this study was to review our institution's experience with subanesthetic doses of propofol for the abortive treatment of pediatric migraine and compare propofol with standard abortive therapy in the PED. METHODS: Retrospective review of all patients discharged from the Oregon Health and Science University PED with a diagnosis of migraine headache from January 2010 to July 2011. Patients treated with subanesthetic doses of propofol were compared with matched controls who received standard abortive migraine therapy, defined as the combined use of a nonsteroidal anti-inflammatory medication, diphenhydramine, and prochlorperazine. Outcome variables of interest included reduction of pain as measured on a self-reported visual analog scale and length of stay after administration of initial abortive medication. RESULTS: Patients who received subanesthetic doses of propofol achieved significantly greater reduction in pain scores (80.1{\%} vs 61.1{\%}; P <0.05) compared with matched controls as well as shorter stay (122 minutes vs 203 minutes; P = 0.2) after treatment. No adverse effects (hypotension, respiratory depression, or hypoxia) were recorded in either group. CONCLUSIONS: Propofol seems to be effective for the abortive treatment of pediatric migraine headache in the PED. Further prospective trials are warranted to either support or refute these initial findings.",
keywords = "abortive, headache, migraine, propofol",
author = "Sheridan, {David C.} and Spiro, {David M.} and Thuan Nguyen and Koch, {Thomas K.} and Meckler, {Garth D.}",
year = "2012",
month = "12",
doi = "10.1097/PEC.0b013e3182768a6b",
language = "English (US)",
volume = "28",
pages = "1293--1296",
journal = "Pediatric Emergency Care",
issn = "0749-5161",
publisher = "Lippincott Williams and Wilkins",
number = "12",

}

TY - JOUR

T1 - Low-dose propofol for the abortive treatment of pediatric migraine in the emergency department

AU - Sheridan, David C.

AU - Spiro, David M.

AU - Nguyen, Thuan

AU - Koch, Thomas K.

AU - Meckler, Garth D.

PY - 2012/12

Y1 - 2012/12

N2 - OBJECTIVE: Limited progress has been made in the past decade for abortive treatment of migraine headache in the pediatric emergency department (PED). Propofol, a general anesthetic, has been reported to be effective in the treatment of refractory headaches in adults at subanesthetic doses but never in the pediatric population. The goal of this study was to review our institution's experience with subanesthetic doses of propofol for the abortive treatment of pediatric migraine and compare propofol with standard abortive therapy in the PED. METHODS: Retrospective review of all patients discharged from the Oregon Health and Science University PED with a diagnosis of migraine headache from January 2010 to July 2011. Patients treated with subanesthetic doses of propofol were compared with matched controls who received standard abortive migraine therapy, defined as the combined use of a nonsteroidal anti-inflammatory medication, diphenhydramine, and prochlorperazine. Outcome variables of interest included reduction of pain as measured on a self-reported visual analog scale and length of stay after administration of initial abortive medication. RESULTS: Patients who received subanesthetic doses of propofol achieved significantly greater reduction in pain scores (80.1% vs 61.1%; P <0.05) compared with matched controls as well as shorter stay (122 minutes vs 203 minutes; P = 0.2) after treatment. No adverse effects (hypotension, respiratory depression, or hypoxia) were recorded in either group. CONCLUSIONS: Propofol seems to be effective for the abortive treatment of pediatric migraine headache in the PED. Further prospective trials are warranted to either support or refute these initial findings.

AB - OBJECTIVE: Limited progress has been made in the past decade for abortive treatment of migraine headache in the pediatric emergency department (PED). Propofol, a general anesthetic, has been reported to be effective in the treatment of refractory headaches in adults at subanesthetic doses but never in the pediatric population. The goal of this study was to review our institution's experience with subanesthetic doses of propofol for the abortive treatment of pediatric migraine and compare propofol with standard abortive therapy in the PED. METHODS: Retrospective review of all patients discharged from the Oregon Health and Science University PED with a diagnosis of migraine headache from January 2010 to July 2011. Patients treated with subanesthetic doses of propofol were compared with matched controls who received standard abortive migraine therapy, defined as the combined use of a nonsteroidal anti-inflammatory medication, diphenhydramine, and prochlorperazine. Outcome variables of interest included reduction of pain as measured on a self-reported visual analog scale and length of stay after administration of initial abortive medication. RESULTS: Patients who received subanesthetic doses of propofol achieved significantly greater reduction in pain scores (80.1% vs 61.1%; P <0.05) compared with matched controls as well as shorter stay (122 minutes vs 203 minutes; P = 0.2) after treatment. No adverse effects (hypotension, respiratory depression, or hypoxia) were recorded in either group. CONCLUSIONS: Propofol seems to be effective for the abortive treatment of pediatric migraine headache in the PED. Further prospective trials are warranted to either support or refute these initial findings.

KW - abortive

KW - headache

KW - migraine

KW - propofol

UR - http://www.scopus.com/inward/record.url?scp=84871625132&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84871625132&partnerID=8YFLogxK

U2 - 10.1097/PEC.0b013e3182768a6b

DO - 10.1097/PEC.0b013e3182768a6b

M3 - Article

C2 - 23187986

AN - SCOPUS:84871625132

VL - 28

SP - 1293

EP - 1296

JO - Pediatric Emergency Care

JF - Pediatric Emergency Care

SN - 0749-5161

IS - 12

ER -