Clinical outcomes of children treated with intravenous prochlorperazine for migraine in a pediatric emergency department.

Abstract

BACKGROUND:

Prochlorperazine is the only treatment that has been studied so far in a randomized controlled trial and found to reduce pain at 1 h in children with migraine who presented to an emergency department (ED).

OBJECTIVE:

To evaluate the rate of treatment failure associated with prochlorperazine used in children with severe migraine in a pediatric ED.

METHODS:

This study was a retrospective chart review of patients < 18 years of age who visited the ED of a tertiary care pediatric hospital between November 2005 and June 2007. All patients diagnosed with migraine by the emergency physicians were included in the study. Charts were evaluated by a data abstractor blinded to the study hypothesis using a standardized datasheet. Inter-rater agreement was measured. Prochlorperazine treatment failure was defined as either administration of further rescue therapy, a hospitalization, or a return visit to the ED within 48 h for symptom recurrence or side effects from the medication.

RESULTS:

Prochlorperazine was administered in 92 episodes of migraine, including 43 confirmed by a pediatric neurologist; all received diphenhydramine to prevent akathisia. A total of 13 (14%) of these patients had a treatment failure: 8 patients received one or more further rescue therapies after the administration of prochlorperazine; 5 patients were hospitalized, including 3 who had received further rescue therapy; and 3 patients returned to the ED within 48 h due to symptom recurrence.

CONCLUSION:

There was a treatment failure rate of 14% with the use of prochlorperazine in association with diphenhydramine for severe migraine in children seen in a pediatric ED.

• Authors: Evelyne D Trottier, Benoit Bailey, Sabine Dauphin-Pierre, Jocelyn Gravel
• Journal: The Journal of emergency medicine (J Emerg Med) Vol. 39 Issue 2 Pg. 166-73 (Aug 2010) ISSN: 0736-4679 [Print] United States
• PMID: 19150192 (Publication Type: Journal Article)
• Copyright: Copyright 2010 Elsevier Inc. All rights reserved.

Chemical References

• Dopamine Antagonists
• Hypnotics and Sedatives
• Diphenhydramine
• Prochlorperazine

Topics

• Adolescent
• Child
• Diphenhydramine (administration & dosage)
• Dopamine Antagonists (administration & dosage)
• Drug Therapy, Combination
• Emergency Service, Hospital
• Female
• Humans
• Hypnotics and Sedatives (administration & dosage)
• Infusions, Intravenous
• Male
• Medical Audit
• Migraine Disorders (drug therapy)
• Pain Measurement
• Prochlorperazine (administration & dosage)
• Retrospective Studies
• Treatment Failure