General anesthesia can help with chronic migraines

Municipal anesthetic lidocaine may help ‘break the cycle’ of pain in hospitalized patients with chronic migraines, a new study reveals.

Lidocaine infusions have been suggested as a possible treatment option for people who have a poor quality of life due to chronic migraine that is resistant to treatment. The goal is to break the ‘cycle’ of pain, but few studies have looked at the effectiveness of this treatment outside of immediate pain relief, according to the study’s authors.

The authors analyzed the hospital records of 609 patients admitted with refractory chronic migraine and treated with lidocaine infusions to assess the short- and medium-term benefits of this approach.

Patients included in the analysis had experienced at least eight debilitating headache days a month for at least six months and failed to respond to or had inconsistencies in the seven classes of migraine medications. They received lidocaine infusions over several days along with other aggressive drug treatments for migraines, such as ketorolac, magnesium, dihydroergotamine, methylprednisolone, and neuroleptics.

Most patients (87.8%) experienced rapid pain relief. At the time of admission, the median rating was given by patients 7.0 and this decreased to 1.0 by the time of hospital discharge.

Patients who attended follow-up appointments about one month after discharge also reported that the number of headache days they experienced had dropped. The 266 patients who attended these appointments, which took place between 25 and 65 days after discharge, said the number of headache days in the last month had dropped from an average of 26.8 to 22.5.

Some patients experienced abuse and vomiting during treatment, but all adverse events experienced were mild.

“Continuous lidocaine infusions were associated with improvement in acute pain in most patients and a decrease in both mean pain and the number of headache days per month which extended to 1 month. Most patients were acute responders, 43% of who maintained improvement at 1 month and were consistent responders, ”the authors concluded.

“Lidocaine may be a viable treatment option for patients with refractory chronic migraine who have failed other treatments. A prospective, randomized, double-blind trial is needed to confirm these results,” she said.

The study was published in the journal Regional Anesthesia & Pain Medicine.

Image Credit: © Wilusz

General anesthesia can help with chronic migraines

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