I sobbed, I begged him to get me out of there. I was on all fours on the ER bed, rocking, crying, hitting the call light like my life depended on it. I felt as though I was out of my own body, trapped in my skin. Within 60 seconds my world felt like it was coming to a complete end. They did the usual migraine cocktail + anti nausea med (Compazine).
I can not believe this many people have had the same experiences."įor Anxiety "I was admitted to the ER for a severe migraine. I have been up and down all day even though my body is exhausted. Severe panic of ending up in the hospital for what’s wrong with me. Saying it can cause “uneasiness” in people. The new nurse comes in and knew what was wrong with me. My husband kept saying I bet it’s the medications. I attributed it to my panic attacks I get occasionally. My heart monitor & I would have ripped that IV out too. I just kept yelling I want to go home! I took off my blood pressure cuff. My husband told the dr and nurse I was have extreme anxiety and they both kept shrugging it off. I canceled my ultrasound test so I could get out quicker.
But a few minutes later while I was talking to the dr I started getting extremely panicked. Epub 2022 Mar 10.For Anxiety "I went to the ER last night for a migraine and other issues. I will continue to use parenteral ketorolac as part of my initial multi-modal migraine cocktail in patients who do not have a contraindication to its use.Įfficacy of ketorolac in the treatment of acute migraine attack: A systematic review and meta-analysis. Overall, due to the paucity of trials included and the small sample sizes in the single trials, I don’t see any practice changing or confirming data in this meta-analysis. In single trials included in this meta-analysis, the authors also found that ketorolac was more effective in controlling migraine headaches than sodium valproate, dexamethasone, and nasal sumatriptan. There were no trials included that compared ketorolac used in combination with other therapies for acute migraine.Īuthors concluded that ketorolac had similar efficacy in treating acute migraine headache as phenothiazines: mean difference in pain intensity 0.09 (95%CI -0.45 to 0.64) metoclopramide 0.02 (95%CI -0.56 to 0.59). Trials comparing ketorolac and meperidine were removed from the analysis, as opioids are no longer recommended for treatment of migraine headaches.
MIGRAINE COCKTAIL TRIAL
There was a single trial each comparing ketorolac to sumatriptan, dexamethasone, sodium valproate, caffeine, and NSAIDs. Primary outcomes were pain intensity at 1 hour and recurrence of headache post-treatment.
The authors looked at 8 comparisons based on the trials included: parenteral ketorolac versus phenothiazines (prochlorperazine, chlorpromazine), dopamine antagonists (metoclopramide), serotonin agonist (sumatriptan), steroid (dexamethasone), sodium channel blocker (sodium valproate), caffeine, NSAID (diclofenac), and opioid (meperidine).
This was a systematic review and meta analysis that included 13 trials with a total of 944 participants. What did the farmer with a headache say after someone stole his wheat?…No, mi-graines! Does ketorolac offer effective pain relief for migraines in this patient population? Many providers have a “migraine cocktail” that includes ketorolac for the initial treatment of migraine headaches in the ED. Headaches account for approximately 3% of ED visits. This systematic review found IM or IV ketorolac had similar efficacy in treating acute migraine headache as phenothiazines and metoclopramide but was unable to draw significant conclusions about ketorolac in comparison to other therapies or as part of a multi-drug cocktail due to paucity of evidence.
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