Study objective: To compare the effectiveness of IM ketorolac with that of meperidine and hydroxyzine in the treatment of acute migraine headache.
Design: Prospective, randomized, double-blind trial.
Setting: Urban emergency department with an annual census of 42,000 patients.
Participants: Forty-seven adult patients with migraines enrolled on 50 visits.
Interventions: Patients were randomly assigned to receive a single injection of either 60 mg ketorolac (group 1) or 100 mg meperidine and 50 mg hydroxyzine (group 2). Pain assessment was made using both visual-analog and verbal descriptor scales.
Results: At 60 minutes, 15 patients (60%) from group 1 (25) and 14 patients (56%) from group 2 (25) reported a great deal of complete relief (P = .77) Sixty-minute mean pain relief scores (3.35 versus 3.37) were different (P = .76). Nine patients (36%) from group 1 and seven patients (28%) from group 2 required additional analgesia (P = .76).
Conclusion: Ketorolac is as effective as meperidine and hydroxyzine for the treatment of acute migraine headache.