Clinical bottom line
Intranasal and intravenous lignocaine can relieve acute migraine
attacks. However, based on existing research it is unlikely that this
offers any benefit over more standard treatments, and these should
therefore be used in preference.
Lignocaine and other local anaesthetic-type drugs which block
sodium channels have been used to relieve chronic clinical pain. Lignocaine is
an amide type local anaesthetic, and has been studied in the treatment of acute
migraine attacks.
Systematic review
Kalso E, Tramèr MR, Moore RA, McQuay HJ. Systemic
local anaesthetic type drugs in chronic pain: a qualitative systematic review.
Eur J Pain. 1998; 2: 3-14.
-
Date review completed: September 1996
-
Number of trials included: 3
-
Number of patients: 182
-
Control group: placebo or active control
-
Main outcomes: findings from original trials
Inclusion criteria were randomised controlled trials of local
anaesthetic-type drugs for migraine; pain outcomes.
Findings
Three trials of 182 patients were included.
One trial of intranasal lignocaine (20-80 mg) with 81
patients showed significantly better pain relief than placebo.
Two trials looked at intravenous lignocaine. One trial of
intravenous lignocaine (1 mg/kg) was no better than placebo. The second trial
of intravenous lignocaine (up to 2.7 mg/kg) was not as effective as intravenous
chlorpromazine, but as effective as intravenous dihydroergotamine.
Adverse effects
Minor local adverse effects were reported for intranasal and
intravenous lignocaine, but there were no drug-related withdrawals.
Related topics
- Identifier CP079 - 1904 LIGNOCAINE FOR ACUTE MIGRAINE: Jul-99
|
