Talabi Saeid, Masoumi Babak, Azizkhani Reza, Esmailian Mehrdad
Department of Emergency Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2013 Aug;18(8):695-8.
There are different options to manage benign headache in the emergency department. The costs, side effects, and efficacies of the drugs used are significantly different. The aim of this study was to compare intravenous (IV) metoclopramide with subcutaneous (SC) sumatriptan in treatment of migraine headache.
In a randomized, double-blinded clinical trial study, patients presenting to the university referral emergency department with acute benign headache were allocated into two groups after obtaining their informed consent. Patients received 20 mg of IV metoclopramide or 6 mg of SC sumatriptan. Pain intensity was assessed with 10-cm visual analog scale at baseline and 60 min after treatment.
One hundred and twenty-four subjects participated. The mean age was 34.9 ± 9 years in metoclopramide group and 26.8 ± 4 years in sumatriptan group (P < 0.0001). The baseline pain scores were 6.47 ± 0.84 and 6.12 ± 0.73 in metoclopramide and sumatriptan groups, respectively (P < 0.0001). The mean of pain score decreased to 0.66 ± 0.59 cm (P < 0.0001) in the metoclopramide group and 1.1 ± 0.70 (P < 0.0001) in the sumatriptan group. Comparison of these two groups showed more pain reduction in the metoclopramide group, with a mean difference of 0.55 ± 0.13 between the groups (95% CI: 0.25-0.79 cm) (P < 0.0001).
For treatment of migraine headache, IV metoclopramide may be superior to SC sumatriptan in the emergency department.
急诊科治疗良性头痛有不同的选择。所用药物的成本、副作用和疗效存在显著差异。本研究的目的是比较静脉注射甲氧氯普胺与皮下注射舒马曲坦治疗偏头痛的效果。
在一项随机、双盲临床试验研究中，到大学附属医院急诊科就诊的急性良性头痛患者在获得知情同意后被分为两组。患者分别接受20毫克静脉注射甲氧氯普胺或6毫克皮下注射舒马曲坦。在基线和治疗后60分钟，用10厘米视觉模拟量表评估疼痛强度。
124名受试者参与研究。甲氧氯普胺组的平均年龄为34.9±9岁，舒马曲坦组为26.8±4岁（P<0.0001）。甲氧氯普胺组和舒马曲坦组的基线疼痛评分分别为6.47±0.84和6.12±0.73（P<0.0001）。甲氧氯普胺组的疼痛评分平均降至0.66±0.59厘米（P<0.0001），舒马曲坦组降至1.1±0.70（P<0.0001）。两组比较显示，甲氧氯普胺组的疼痛减轻更明显，两组之间的平均差异为0.55±0.13（95%CI：0.25 - 0.79厘米）（P<0.0001）。
在急诊科治疗偏头痛时，静脉注射甲氧氯普胺可能优于皮下注射舒马曲坦。
