Refractory Migraine May Benefit From Ketamine Infusions

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Sub-anesthetic ketamine infusions improved short-term analgesia in patients with refractory headaches.
Sub-anesthetic ketamine infusions improved short-term analgesia in patients with refractory headaches.

HealthDay News — Sub-anesthetic ketamine infusions are associated with improved short-term pain relief for migraine and other intractable headache, according to a study presented at the annual meeting of the American Society of Anesthesiologists, being held Oct. 21 to 25 in Boston.

Ashwin Rangavajjula, MD, from Thomas Jefferson University Hospital in Philadelphia, and colleagues reviewed data for 61 patients who received ketamine infusions for migraine or other intractable headaches. Data were obtained from the daily acute pain notes and electronic medical records.

The researchers found that the mean headache pain rating was 7.5±0.2 at admission and 3.4 ±0.3 at discharge. A statistically significant difference was seen between the initial, lowest, and end pain rating. The mean length of ketamine infusion was 5.1 days, with the lowest pain rating on day 4, which was achieved at mean ketamine rates of 30.8±3.6 mg/hr less than the maximum dose. Generally mild adverse events occurred but did not result in discontinuation of infusion, except for one patient who requested discontinuation after one day of treatment.

"Ketamine may hold promise as a treatment for migraine headaches in patients who have failed other treatments," one of the co-authors said in a statement. "Our study focused only on short-term relief, but it is encouraging that this treatment might have the potential to help patients long-term."

Disclosure: One author disclosed ties to the pharmaceutical industry.

Reference

Rangavajjula A, Hernandez M, Dayan AC, Schwenk ES, Viscusi ER. The use of ketamine infusions for refractory headaches: a restrospective analysis. Presented at: 2017 American Society of Anesthesiologists Annual Meeting. October 21-25, 2017; Boston, MA. Abstract A1065.

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