Treating primary headaches in the ED: can droperidol regain its role?

Abstract

OBJECTIVE:

The aim of this study was to describe the use and efficacy of low-dose (≤2 mg) droperidol for the treatment of primary headaches (ie, migraine, cluster, tension-type headache and trigeminal autonomic cephalalgias, and other primary headaches) in the emergency department (ED).

METHODS:

A report was generated from a pharmacy database to identify all adult patients who received low-dose droperidol in the ED over a 7-month period; a subsequent retrospective chart review was conducted. Low-dose droperidol was defined as a cumulative dose of ≤2 mg. Patients who received droperidol for any other reason than the treatment of a headache were excluded. Data were analyzed descriptively.

RESULTS:

Seventy-three cases in which droperidol was administered for the treatment of a headache were identified over the 7-month period. Most doses (92%) administered were 1.25 mg or less. Fifty-three patients (73%) had complete resolution or significant improvement of headache symptoms as subjectively or objectively (eg, numerical pain scale) documented by the treating physician. Eight patients (11%) had minimal improvement in their headaches symptoms; 12 patients (16%) received no relief after the administration of droperidol. The average time to discharge from the ED was 94.8 ± 67.2 minutes. No cardiac arrhythmias were noted. Other adverse events included 2 cases of extrapyramidal side effects; one patient reported restlessness/anxiousness and the other patient had dystonia.

CONCLUSION:

The administration of low-dose (≤2 mg) droperidol may be safe and effective for the treatment of primary headaches in the ED.

• Authors: Brett Faine, Christopher Hogrefe, Jon Van Heukelom, Jamie Smelser
• Journal: The American journal of emergency medicine (Am J Emerg Med) Vol. 30 Issue 7 Pg. 1255-62 (Sep 2012) ISSN: 1532-8171 [Electronic] United States
• PMID: 22030187 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Published by Elsevier Inc.

Chemical References

• Analgesics
• Droperidol

Topics

• Adult
• Analgesics (administration & dosage, adverse effects, therapeutic use)
• Basal Ganglia Diseases (chemically induced)
• Droperidol (administration & dosage, adverse effects, therapeutic use)
• Emergency Service, Hospital
• Female
• Headache (drug therapy)
• Humans
• Male
• Pain Management
• Pain Measurement
• Retrospective Studies