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Low-Dose Propofol for Pediatric Migraine: A Prospective, Randomized Controlled Trial
David C Sheridan1, Matthew L Hansen1, Amber L Lin1
1Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon.
The Journal of Emergency Medicine
|February 20, 2018
Summary
Low-dose propofol (LDP) did not improve pain reduction for pediatric migraine compared to standard therapy. However, LDP significantly reduced rebound headaches and showed a trend toward shorter emergency department length of stay.
Area of Science:
- Pediatric Emergency Medicine
- Neurology
- Pharmacology
Background:
- Pediatric migraine is a frequent cause of emergency department visits.
- Sub-anesthetic doses of propofol show potential for treating migraines, possibly reducing length of stay.
Purpose of the Study:
- To compare the efficacy of low-dose propofol (LDP) against standard therapy (ST) for pediatric migraine treatment.
Main Methods:
- A prospective, pragmatic randomized controlled trial was conducted in two pediatric emergency departments.
- Patients aged 7-19 with migraines and high pain scores were randomized to LDP or ST.
- Primary outcome was pain reduction; secondary outcomes included emergency department length of stay, rebound headaches, and return visits.
Main Results:
- No significant difference in pain reduction between LDP (51%) and ST (59%).
- Significantly fewer rebound headaches occurred in the LDP group (25.0%) compared to ST (66.7%).
- A trend towards shorter median length of stay favored LDP (79 min vs. 111 min).
Conclusions:
- Low-dose propofol is not superior to standard therapy for pain reduction in pediatric migraines.
- Low-dose propofol significantly reduces 24-hour rebound headaches and may shorten emergency department length of stay.
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