scholarly journals Intravenous chlorpromazine in the acute treatment of episodic tension-type headache: a randomized, placebo controlled, double-blind study

2002 ◽  
Vol 60 (3A) ◽  
pp. 537-541 ◽  
Author(s):  
Marcelo Eduardo Bigal ◽  
Carlos Alberto Bordini ◽  
José Geraldo Speciali
Keyword(s):  
Acute Treatment ◽  
Tension Type Headache ◽  
Blind Study ◽  
Number Needed To Treat ◽  
Double Blind Study ◽  
Emergency Rooms ◽  
Double Blind ◽  
Therapeutic Gain ◽  
Type Headache ◽  
To Receive

Acute headache is a very frequent symptom, responsible for a significant percentage of caseload at primary care units and emergency rooms. Chlorpromazine is easily available in such settings. The aim of this study is to conduct a randomized, placebo-controlled, double-blind study to assess the efficacy of chlorpromazine on the acute treatment of episodic tension-type headache. We randomized 30 patients to receive placebo (10 ml of saline intravenous injections) and 30 patients to receive 0.1 mg/Kg chlorpromazine intravenously. We used 7 parameters of analgesic evaluation. Patients receiving chlorpromazine showed a statistically significant improvement (p < 0.05 and p < 0.01) of pain compared to placebo, far up to 30 minutes after the drug administration. The therapeutic gain was 36.7% in 30 minutes and 56.6 % in 60 minutes. The number needed to treat (NNT, the reciprocal or the therapeutic gain) was 2.7 in 30 minutes and 1.8 in 60 minutes. There were reductions in the recurrence and in the use of rescue medication in the chlorpromazine group. We can conclude that intravenous chlorpromazine is an effective drug to relief the pain in tension-type headache.

Amitriptylin Versus Amitriptyline-N-Oxide versus Placebo in the Treatment of Chronic Tension Type Headache: A Multi-Centre, Randomised Parallel-Group Double-Blind Study.

Cephalalgia ◽  
1991 ◽  
Vol 11 (11_suppl) ◽  
pp. 329-330 ◽  
Author(s):  
Volker Pfaffenrath ◽  
Hans-Christoph Diener ◽  
Hans-Ruedi Isler ◽  
Christian Meyer ◽  
Zia Taneri ◽  
...  
Keyword(s):  
Tension Type Headache ◽  
Blind Study ◽  
Double Blind Study ◽  
Double Blind ◽  
Chronic Tension Type Headache ◽  
Parallel Group ◽  
Type Headache

Effectiveness of Oral Diclofenac in the Acute Treatment of Common Migraine Attacks: A Double-Blind Study Versus Placebo

Cephalalgia ◽  
1991 ◽  
Vol 11 (2) ◽  
pp. 59-63 ◽  
Author(s):  
Hélène Massiou ◽  
Dominique Serrurier ◽  
Odile Lasserre ◽  
Marie-Germaine Bousser
Keyword(s):  
Clinical Relevance ◽  
Acute Treatment ◽  
Migraine Without Aura ◽  
International Headache Society ◽  
Blind Study ◽  
Drug Intake ◽  
Double Blind Study ◽  
Double Blind ◽  
The One

In a multicentre double-blind cross-over trial, oral diclofenac at a dose of 50 mg to 100 mg was compared to placebo in the acute treatment of migraine attacks. A hundred and seven patients suffering from migraine without aura were included, and 91 were analysed for efficacy; they had to treat four successive attacks-two with diclofenac and two with placebo. Diclofenac was significantly more effective than placebo ( p < 0.05) on the main judgement parameter, which was the number of attacks aborted within 2 h of drug intake, as well as on the following secondary parameters: the necessity for an escape medication and the evaluation of global efficacy. Diclofenac was well tolerated. This trial demonstrates the efficacy of diclofenac in the acute treatment of migraine attacks. It confirms the good clinical relevance of the main judgement parameter chosen, which is the one recommended by the International Headache Society, but appears to be a severe one in terms of successes.

scholarly journals Peritonsillar Infiltration with Bupivacaine for Paediatric Tonsillectomy

1994 ◽  
Vol 22 (6) ◽  
pp. 679-682 ◽  
Author(s):  
J. C. Stuart ◽  
F. B. Macgregor ◽  
C. S. Cairns ◽  
H. R. Chandrachud
Keyword(s):  
Pain Score ◽  
Severe Pain ◽  
Blind Study ◽  
Double Blind Study ◽  
Double Blind ◽  
Peritonsillar Infiltration ◽  
Induction Of Anaesthesia ◽  
To Receive

In a double-blind study forty-two children scheduled for elective adenotonsillectomy were randomized to receive peritonsillar infiltration, following induction of anaesthesia, with either 0.25% plain bupivacaine or 0.9% saline, 0.5 ml/kg to a maximum of 10 ml. The children were assessed on awakening, and then 10 minutes, 1 hour, 4 hours and 24 hours later. On each occasion the observer gave the child a pain score from 1 (no pain) to 5 (severe pain). The scores on awakening and after 10 minutes were significantly lower in the bupivacaine group (P< 0.05, Mann-Whitney U test). Thereafter there was no difference between the groups. The authors conclude that peritonsillar infiltration with bupivacaine is only moderately useful as analgesia for children having tonsillectomy.

A Double-Blind Study of Ibuprofen Versus Placebo in the Treatment of Acute Migraine Attacks

Cephalalgia ◽  
1992 ◽  
Vol 12 (3) ◽  
pp. 169-171 ◽  
Author(s):  
Reidar Kloster ◽  
Knut Nestvold ◽  
Steinar T Vilming
Keyword(s):  
Side Effects ◽  
Initial Dose ◽  
Acute Treatment ◽  
Blind Study ◽  
Double Blind Study ◽  
Acute Migraine ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Inflammatory Drug ◽  
Anti Inflammatory

The efficacy of ibuprofen, a non-steroidal anti-inflammatory drug, was assessed in the acute treatment of migraine. Twenty-five patients completed a double-blind placebo-controlled multicrossover trial. The initial dose of ibuprofen was 1200 mg. Six migraine attacks were randomly treated in each patient, three with ibuprofen and three with placebo. The results indicated a statistically significant reduction in the duration of the migraine attacks and also a statistically significant reduction in the severity of headache and nausea in the ibuprofen-treated attacks. The use of additional medication was significantly reduced in the ibuprofen-treated attacks (25.6% vs 57.5%), No serious side effects were reported. Ibuprofen is valuable in the treatment of acute migraine attacks.

scholarly journals Comparison between intrathecal nalbuphine and butorphanol as adjuvants to isobaric ropivacaine in elective lower limb orthopedic surgeries: A prospective, randomized, double blind study

2020 ◽  
Author(s):  
Akash Nirmal ◽  
Yashpal Singh ◽  
Sharad Kumar Mathur ◽  
Satish Patel
Keyword(s):  
Postoperative Analgesia ◽  
Lower Limb ◽  
Primary Outcome Measure ◽  
Blind Study ◽  
Double Blind Study ◽  
Motor Blockade ◽  
Chi Square ◽  
Double Blind ◽  
Lower Limb Surgery ◽  
To Receive

Background: Intrathecal ropivacaine is now routinely used for lower limb surgery. Adjuvants e.g. fentanyl, dexmedetomidine or morphine etc. are commonly used to prolong the intraoperative anesthesia or postoperative analgesia. The available literature lacks information on use of butorphanol and nalbuphine as adjuvants with 0.75% isobaric ropivacaine. We aimed to compare nalbuphine and butorphanol as adjuvant with isobaric ropivacaine in lower limb orthopedic surgeries. Methodology: After institutional ethical committee approval and informed written consent, a total of 108 patients of ages between 18 to 65 y, of either sex, American Society of Anesthesiologists (ASA) grade ӏ & ӏӏ, scheduled for elective lower limb orthopedic surgeries, were enrolled and  randomly allocated into two groups: Group RN; to receive isobaric ropivacaine (0.75%, 7.5 mg/ml) 2.5 ml plus nalbuphine 500 µg (0.5 ml), and Group RB; to receive isobaric ropivacaine 2.5 ml plus butorphanol 100 µg (0.5 ml) intrathecally. Primary outcome measure was the duration of sensory‑motor blockade from the time of intrathecal drug administration. Statistical analysis was performed by using t-test and chi-square test as applicable. A p < 0.05 was considered as significant. Results: Duration of sensory (p < 0.001) and motor blockade (p = 0.02) was significantly prolonged in nalbuphine group than butorphanol group. Onset of blockade was earlier in nalbuphine group. Duration of motor block and sensory analgesia was prolonged in group RN (p < 0.001). Perioperative hemodynamic parameters and the observed side effects including bradycardia, hypotension, nausea and vomiting, sedation and shivering were comparable between the two groups (p = 0.77). Conclusion: Intrathecal nalbuphine produces prolonged motor blockade as well as postoperative analgesia than intrathecal butorphanol when used as adjuvants to isobaric 0.75% ropivacaine. Citation: Nirmal A, Singh Y, Mathur SK, Patel S. Comparison between intrathecal nalbuphine and butorphanol as adjuvants to isobaric ropivacaine in elective lower limb orthopedic surgeries: A prospective, randomized, double blind study. Anaesth pain & intensive care 2019;23(4)__ Received: 22 August 2019; Reviewed: 8, 9 October 2019; 6, 7 November 2019; Revised: 18 November 2019; Reviewed: 19 November 2019; Accepted: 20 November 2019

Headache Classification by History has Only Limited Predictive Value for Headache Episodes Treated in Controlled Trials With OTC Analgesics

Cephalalgia ◽  
2009 ◽  
Vol 29 (2) ◽  
pp. 188-193 ◽  
Author(s):  
H-C Diener ◽  
V Pfaffenrath ◽  
L Pageler ◽  
H Peil ◽  
B Aicher ◽  
...  
Keyword(s):  
International Headache Society ◽  
Tension Type Headache ◽  
Initial Diagnosis ◽  
Prior History ◽  
Double Blind Study ◽  
Double Blind ◽  
Efficacy Analysis ◽  
Headache Type ◽  
Headache Diagnosis ◽  
Type Headache

We investigated the consistency between the headache diagnosis based on medical history and three treated headache episodes diagnosed based on a diary. In a randomized double-blind study including individuals with either migraine or tension-type headache (TTH) we showed significant superiority of the fixed combination of acetylsalicylic acid + paracetamol + caffeine over the combination without caffeine, the single preparations, and placebo in the treatment of headache. A neurologist performed a classification of the usual headache episodes and each of the three treated ones in a blinded fashion based on a structured questionnaire. This was done for the 1734 patients included in the efficacy analysis who usually treated their episodic TTH or migraine attacks with non-prescription analgesics. The overall percentage of patients with migraine and TTH remained relatively stable. The treated headache episodes were between 75 and 77% migraine, 18–20% were TTH and 5–7% could not be classified. We observed some shift in headache type within patients from prior history and in treated attacks. In 60% of patients all three treated episodes were of the type initially diagnosed by the neurologist by history (56% migraine and 4% episodic TTH). Of those with an initial diagnosis of migraine, 24% had at least one attack meeting criteria for TTH. Of patients with an initial diagnosis of TTH, 54% had at least one attack meeting the diagnostic criteria for migraine. Our results demonstrate that an initial headache diagnosis does not accurately predict the headache type treated in a randomized trial. Symptom features of treated headaches should be captured to ensure that the attack is of the type targeted by the clinical trial. The International Headache Society Guidelines for controlled clinical trials should be updated accordingly.

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