Headache is a common and frequently disabling clinical disorder that accounts for nearly 2% of all emergency department presentations. Often patients are experiencing a headache that is not responding to commonly available medications. However, there is no good evidence to support which available hospital medications consistently offer effective pain relief to individuals with these types of refractory headache. Understandably this is a challenging scenario in the emergency department setting for both the patient and physician that often leads to inadequate or unsatisfactory symptom relief.
In a few small trials, there has been promising evidence that the medication propofol is potentially an effective, safe and quick treatment alternative for stubborn headaches. It is important to note that propofol is not a new medication and is routinely used on a daily basis throughout hospitals for both general anaesthesia and procedural sedation.
It is the intention of this research project to demonstrate that infusing a low dose of this medication over a relatively short period of time is an effective new use for a familiar and already commonly utilised medication. This treatment is aimed at a specific cohort of patients who present with acute or subacute migraine-like headache in whom the standard available treatment options have failed.
This study has the potential to introduce a new safe and effective treatment option for stubborn headaches that can significantly reduce treatment times by rapidly restoring patients to baseline levels of function and comfort. Furthermore it reduces overall lengths of stay in the emergency department and contributes to overall improved emergency department patient flow.
This pilot study demonstrates that a continuous infusion of low dose propofol is both an effective and safe treatment option for patients presenting to the emergency department with persistent migraines. Even though the use of propofol is still necessarily a more labour and resource intensive modality, it is an effective treatment option for consideration when other treatments have failed.
- $10,544.60 [Redcliffe Hospital Private Practice Trust Fund Advisory Committee grant]