• Am J Emerg Med · Sep 2012

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

    • Brett Faine, Christopher Hogrefe, Jon Van Heukelom, and Jamie Smelser.
    • Department of Emergency Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA. brett-faine@uiowa.edu
    • Am J Emerg Med. 2012 Sep 1;30(7):1255-62.

    ObjectiveThe 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).MethodsA 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.ResultsSeventy-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.ConclusionThe administration of low-dose (≤2 mg) droperidol may be safe and effective for the treatment of primary headaches in the ED.Published by Elsevier Inc.

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