A randomized, double-blind, comparative study of the efficacy of ketorolac tromethamine versus meperidine in the treatment of severe migraine

Department of Surgery, West Virginia University Health Sciences Center, Morgantown.
Annals of Emergency Medicine (Impact Factor: 4.68). 09/1992; 21(8):919-24. DOI: 10.1016/S0196-0644(05)82928-2
Source: PubMed


To evaluate the relative efficacy of ketorolac tromethamine and meperidine hydrochloride in the emergency department treatment of severe migraine.
Prospective, randomized, double-blind trial.
University hospital ED.
Patients presenting to the ED with an isolated diagnosis of common or classic migraine.
Subjects were randomized to receive a single intramuscular injection of either 30 mg ketorolac or 75 mg meperidine.
Of the 31 patients completing the trial, 15 received ketorolac and 16 received meperidine. The demographic characteristics of both groups were comparable. At one hour, ketorolac was significantly less effective than meperidine in reducing headache pain (P = .02) and in improving clinical disability (P = .01). Ketorolac also was less effective at reducing nausea, photophobia, and the need for rescue medication (P less than .05). Sustained headache relief was experienced by 44% of the patients treated with meperidine at 12- to 24-hour follow-up, compared with 13% of the patients treated with ketorolac (P = NS). No significant side effects were observed for either group.
IM ketorolac tromethamine is less effective than meperidine in the ED treatment of severe migraine.

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Available from: Gregory Luke Larkin, Aug 28, 2015
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    • "Intramuscular ketorolac 30 mg had less efficacy than 75 mg meperidine [114], but a dose of 60 mg was as effective as 75 mg meperidine (plus 25 mg promethazine) [115] or 100 mg meperidine (plus 50 mg hydroxyzine) or 25 mg chlorpromazine iv [116] in rather small randomized trials performed in emergency departments (n = 30 to 47 patients included). Ketorolac 30 mg iv (n = 64) was inferior to 10 mg iv prochlorperazine [117], but more effective than 20 mg nasal sumatriptan (n = 29) [118]. "
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