Intravenous caffeine versus intravenous ketorolac for the management of moderate to severe migraine headache

Abstract

<p class="Abstract">The aim of this study was to determine if intravenous caffeine is as effective as intravenous ketorolac for the treatment of moderate to severe migraine headaches. Eligible patients randomly received 60 mg caffeine citrate or 60 mg ketorolac infused intravenously. Their pain score were measured at baseline, one hour and two hours after infusion. Therapeutic success was defined as decreasing of at least 3 points on the pain score. In total 110 patients were enrolled (75.5% women). Therapeutic success after 60 min was achieved by 63.6% of patients in the caffeine and 70.1% of patients in the ketorolac group (p = 0.23). After 120 min, 87.3% of the caffeine group and 83.6% of the ketorolac group achieved therapeutic success (p = 0.49). In this multi-center, randomized double blind study, intravenous caffeine was as effective as intravenous ketorolac for first line abortive management of acute migraine.</p><p> </p>

Intravenous caffeine citrate vs. magnesium sulfate for reducing pain in patients with acute migraine headache; a prospective quasi-experimental study

“…The acetaminophen/aspirin /caffeine cocktail is classified as a level one option for acute migraine attacks by the American Headache Society, whilst the combination of caffeine and ergotamine is listed as level two [ 2 ]. We initiated the use of caffeine as monotherapy in a pilot study followed by an RCT comparing intravenous caffeine and ketorolac [ 20 21 ]. Both regimens showed comparable positive effect in terms of pain relief, therapeutic success, and incidence of adverse events [ 20 21 ].…”

“…Combinations of caffeine with non-opioid analgesics, ergotamine and codeine showed an abortive effect in acute episodes of migraine [ 17 18 19 ]. In two recent trials, we reported that intravenous caffeine has comparable efficacy to ketorolac for ameliorating migraine pain [ 20 21 ].…”

“…We have done some studies about the role of caffeine for pain management in acute migraine headache [ 16 ]. We have assessed its efficacy as a sole treatment and also compared it with ketorolac [ 20 21 ]. To the best of our knowledge, there is not any study that uses intravenous caffeine in this regard, except for those belonging to Baratloo et al [ 20 21 ].…”

“…We have assessed its efficacy as a sole treatment and also compared it with ketorolac [ 20 21 ]. To the best of our knowledge, there is not any study that uses intravenous caffeine in this regard, except for those belonging to Baratloo et al [ 20 21 ]. To further these investigations, in the current study, we performed prospective research to assess the efficacy of intravenous caffeine citrate vs. magnesium sulfate for management of acute migraine headache.…”

Effect of Dexmedetomidine Infusion During Orthopedic Surgery on Postoperative Analgesic Consumption in Opium Addict Patients; A Randomized Clinical Trial

“…Inappropriate pain management in different settings, from the emergency department to the operating room and afterward, has been documented in the current literature and research regarding better approach is still ongoing (5)(6)(7)(8). The efficient management of POP is currently a part of surgery process and reduces patients' morbidity as well as their mortality, accelerates recovery and discharge from the hospital, improves patients' quality of life, and reduces costs.…”