Abiri Samaneh, Chegin Mehdi, Soleimani Reza, Hatami Naser, Kalani Navid, Rayatdoost Esmail
Department of Emergency Medicine, Research Center for Noncommunicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran.
Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran.
Arch Acad Emerg Med. 2022 Mar 5;10(1):e19. doi: 10.22037/aaem.v10i1.1561. eCollection 2022.
Acute headache is one of the most common reasons for emergency department (ED) visits. This study aimed to compare the combination of propofol and granisetron with propofol and metoclopramide in symptom management of acute migraine headache.
In this double-blind randomized clinical trial, 60 adult patients with acute migraine headache who referred to ED were randomly divided into two groups of propofol + metoclopramide and propofol + granisetron. Pain and nausea/vomiting severity as well as blood pressure were compared between groups 30, 45, and 60 minutes after treatment.
The two groups had similar situation regarding mean age (p = 0.606), sex distribution (p = 0.793), baseline severity of pain (p = 0.642), frequency of nausea/vomiting (p = 0.488), and vital signs (p > 0.05). The severity of pain was similar in the two groups 30 (p = 0.731), 45 (p = 0.460), and 60 (p = 0.712) minutes after treatment. The number of patients with resistant nausea and vomiting 60 minutes after treatment was significantly higher in metoclopramide group (30.0% versus 10.0%; p = 0.033). Diastolic pressure 60 minutes after treatment (81.43 ±8.94 vs. 74.97 ± 4.8; p = 0.001) and heart rate 30 minutes after treatment (68.87 ±6.52 vs. 73.57± 7.62; p = 0.013) had statistically significant differences between the groups.
The combination of propofol and granisetron was superior to propofol and metoclopramide in case of controlling nausea and vomiting of cases with acute migraine headache; meanwhile, no differences were observed in case of pain relief and hemodynamic status between the two groups.
急性头痛是急诊科就诊的最常见原因之一。本研究旨在比较丙泊酚与格拉司琼联合使用和丙泊酚与甲氧氯普胺联合使用在急性偏头痛症状管理中的效果。
在这项双盲随机临床试验中，60名因急性偏头痛到急诊科就诊的成年患者被随机分为丙泊酚+甲氧氯普胺组和丙泊酚+格拉司琼组。在治疗后30、45和60分钟比较两组的疼痛、恶心/呕吐严重程度以及血压。
两组在平均年龄（p = 0.606）、性别分布（p = 0.793）、基线疼痛严重程度（p = 0.642）、恶心/呕吐频率（p = 0.488）和生命体征（p > 0.05）方面情况相似。治疗后30分钟（p = 0.731）、45分钟（p = 0.460）和60分钟（p = 0.712）时，两组疼痛严重程度相似。治疗60分钟后，甲氧氯普胺组恶心和呕吐难治性患者数量显著更高（30.0%对10.0%；p = 0.033）。治疗60分钟后的舒张压（81.43±8.94对74.97±4.8；p = 0.001）和治疗30分钟后的心率（68.87±6.52对73.57±7.62；p = 0.013）在两组间有统计学显著差异。
在控制急性偏头痛患者的恶心和呕吐方面，丙泊酚与格拉司琼联合使用优于丙泊酚与甲氧氯普胺联合使用；同时，两组在疼痛缓解和血流动力学状态方面未观察到差异。
