Transnasal butorphanol in the emergency department management of migraine headache.

Transnasal butorphanol (TNB) is a mixed agonist-antagonist opioid that has recently been released for the treatment of painful conditions. Patients with a history of migraine diagnosed in either of two emergency departments (EDs) with a moderate or severe migraine were eligible for this prospective study. Patients received 1 mg of TNB at time zero and again in 45 minutes if needed. Twenty-five patients were studied. Pain intensity was measured on a 10-cm visual analog scale. Mean pain intensity was significantly decreased at 15 minutes and declined from 7.9 +/- 1 cm initially to 2.5 +/- 3.3 cm at 90 minutes. Sixty percent of the patients required no further treatment. Thirty-six percent experienced side effects, with all but 1 being mild or moderate. Seventy-five percent rated the treatment as good, very good, or excellent, and 71% would prefer to receive TNB for future migraines over other treatment options. TNB offers rapid, effective pain relief to the majority of ED migraine patients.
AuthorsS W Melanson, J W Morse, D J Pronchik, M B Heller
JournalThe American journal of emergency medicine (Am J Emerg Med) Vol. 15 Issue 1 Pg. 57-61 (Jan 1997) ISSN: 0735-6757 [Print] UNITED STATES
PMID9002572 (Publication Type: Clinical Trial, Journal Article)
Chemical References
  • Analgesics, Opioid
  • Narcotic Antagonists
  • Butorphanol
  • Administration, Intranasal
  • Adult
  • Analgesics, Opioid (administration & dosage, therapeutic use)
  • Butorphanol (administration & dosage, therapeutic use)
  • Female
  • Humans
  • Male
  • Middle Aged
  • Migraine Disorders (drug therapy)
  • Narcotic Antagonists (administration & dosage, therapeutic use)
  • Pain Measurement
  • Patient Satisfaction
  • Prospective Studies
  • Treatment Outcome

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