title: Intranasal Lidocaine in Acute Treatment of Migraine: A Randomized Controlled Trial.
abstract: OBJECTIVE
  The study aims to evaluate the efficacy and safety of intranasal lidocaine administration for migraine treatment.
  
  
  METHODS
  This single-center, double-blind, randomized, controlled trial was conducted in a tertiary care emergency department. Included patients met the migraine criteria of the International Headache Society. Patients were randomized to intranasal lidocaine or saline solution; all participants received 10 mg of intravenous metoclopramide. Patient pain intensity was assessed with an 11-point numeric rating scale score. The primary outcome measure was the change in pain scores at 15 minutes; secondary outcomes were changes in pain intensity after pain onset and need for rescue medication.
  
  
  RESULTS
  Patients (n=162) were randomized into 2 groups with similar baseline migraine characteristics and numeric rating scale scores. The median reduction in numeric rating scale score at 15 minutes was 3 (interquartile range [IQR] 2 to 5) for the lidocaine group and 2 (IQR 1 to 4) for the saline solution group (median difference=1.0; 95% confidence interval 0.1 to 2.1). The reduction in pain score at 30 minutes was 4 (IQR 3 to 7) for the lidocaine group and 5 (IQR 2 to 7) for the saline solution group (median difference=1.0; 95% confidence interval 0.1 to 2.1). Need for rescue medication did not differ between the groups, and local irritation was the most common adverse event in the lidocaine group.
  
  
  CONCLUSIONS
  Although intranasal lidocaine was found no more efficacious than normal saline solution in our study, future studies should focus on patients who present earlier after headache onset.
authors.affiliation: Department of Emergency Medicine, Bitlis State Hospital, Bitlis, Turkey.
authors.forename: Nazire
authors.initials: N
authors.lastname: Avcu
authors.affiliation: Department of Emergency Medicine, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey. Electronic address: nurettinozgurdogan@gmail.com.
authors.forename: Nurettin Özgür
authors.initials: NÖ
authors.lastname: Doğan
authors.affiliation: Department of Emergency Medicine, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Pekdemir
authors.affiliation: Department of Emergency Medicine, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
authors.forename: Elif
authors.initials: E
authors.lastname: Yaka
authors.affiliation: Department of Emergency Medicine, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Yılmaz
authors.affiliation: Department of Emergency Medicine, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
authors.forename: Cansu
authors.initials: C
authors.lastname: Alyeşil
authors.affiliation: Department of Emergency Medicine, Bandırma State Hospital, Bandırma, Turkey.
authors.forename: Latif Erdem
authors.initials: LE
authors.lastname: Akalın
mesh_terms: D000208:Acute Disease; D000281:Administration, Intranasal; D000328:Adult; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000932:Antiemetics / Q000008:administration & dosage; D004311:Double-Blind Method; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage; D008881:Migraine Disorders / Q000188:drug therapy* / Q000503:physiopathology; D010147:Pain Measurement; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D000932:Antiemetics; D008012:Lidocaine; D008787:Metoclopramide