Ketorolac versus meperidine and hydroxyzine in the treatment of acute migraine headache: a randomized, prospective, double-blind trial.
OBJECTIVE
To compare the effectiveness of IM ketorolac with that of meperidine and hydroxyzine in the treatment of acute migraine headache.


METHODS
Prospective, randomized, double-blind trial.


METHODS
Urban emergency department with an annual census of 42,000 patients.


METHODS
Forty-seven adult patients with migraines enrolled on 50 visits.


METHODS
Patients were randomly assigned to receive a single injection of either 60 mg ketorolac (group 1) or 100 mg meperidine and 50 mg hydroxyzine (group 2). Pain assessment was made using both visual-analog and verbal descriptor scales.


RESULTS
At 60 minutes, 15 patients (60%) from group 1 (25) and 14 patients (56%) from group 2 (25) reported a great deal of complete relief (P = .77) Sixty-minute mean pain relief scores (3.35 versus 3.37) were different (P = .76). Nine patients (36%) from group 1 and seven patients (28%) from group 2 required additional analgesia (P = .76).


CONCLUSIONS
Ketorolac is as effective as meperidine and hydroxyzine for the treatment of acute migraine headache.
Duarte
C
C
Department of Emergency Medicine, University of Illinois College of Medicine, Peoria.
Dunaway
F
F
Turner
L
L
Aldag
J
J
Frederick
R
R
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000008:administration & dosage / Q000009:adverse effects; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006919:Hydroxyzine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007273:Injections, Intramuscular; D020911:Ketorolac Tromethamine; D008297:Male; D008614:Meperidine / Q000008:administration & dosage / Q000009:adverse effects; D008881:Migraine Disorders / Q000188:drug therapy*; D010147:Pain Measurement; D011446:Prospective Studies; D013997:Time Factors; D014046:Tolmetin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014325:Tromethamine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D000700:Analgesics; D004338:Drug Combinations; D014325:Tromethamine; D006919:Hydroxyzine; D020911:Ketorolac Tromethamine; D008614:Meperidine; D014046:Tolmetin