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Lidocaine Infusions Beneficial for Refractory Chronic Migraine

Decrease seen in median pain rating from baseline to end of hospitalization; pain rating remained below baseline at postdischarge visit

TUESDAY, May 24, 2022 (HealthDay News) — Lidocaine infusions seem beneficial for refractory chronic migraine, according to a study published online May 23 in Regional Anesthesia & Pain Medicine.

Eric S. Schwenk, M.D., from the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, and colleagues reviewed records for 832 hospital admissions involving continuous multiday lidocaine infusions for migraine among patients meeting the criteria for refractory chronic migraine. Patients received additional migraine medications during hospitalization. The change in headache pain from baseline to hospital discharge was examined as the primary outcome.

A total of 609 patient admissions were included in the analyses. The researchers observed a decrease in the median pain rating from 7.0 at baseline to 1.0 at the end of hospitalization; 87.8 percent of patients were considered acute responders. At postdischarge office visit (25 to 65 days after treatment), the average pain remained below baseline (5.5). At one month, 43 percent of patients were sustained responders. There was a decrease seen in headache days from 26.8 ± 3.9 at baseline to 22.5 ± 8.3 at the postdischarge office visit. The most common adverse drug effects were nausea and vomiting, and they were mild.

“Our results support the use of lidocaine infusions in a challenging population with [refractory chronic migraine] and can help those treating challenging patients with headache have informed discussions about likelihood for relief and expected duration of relief,” the authors write.

One author disclosed financial ties to the biopharmaceutical industry.

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