The Effect of Propofol Anesthesia on the Pain Severity and Frequency of Migraine Attacks in Patients with Chronic Migraine Headache over a Six Month Follow Up: An Observational Study

Document Type : Research article

Authors

1 Anesthesiology Research Center, Department of Anesthesiology and Critical Care, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Department of Anesthesiology and Critical Care, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 Department of Neurology, Islamic Azad University, Medical Branch, Tehran, Iran.

4 Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

10.22037/ijpr.2021.115243.15266

Abstract

ropofol is a short-acting intravenous anesthetic that is commonly used for induction and maintenance of anesthesia. Subanesthetic low doses of propofol has also been used to treat intractable migraine attacks in emergency wards with dramatic results. However, there is little information on the long-term efficacy of this drug in migraine headaches. The aim of this nonrandomized prospective observational study was to assess the effect of propofol anesthesia on the pain severity and frequency of migraine attacks in a 6-month follow-up period after anesthesia in patients with migraine headaches. The study was conducted on 51 known cases of migraine ranging in age from 21 to 66 years. Before anesthesia, patients completed a questionnaire including their characteristics, pain intensity of the headache using a visual analog scale, and a number of headache repetitions per month. All patients received propofol as the main anesthetic agent. At the end of anesthesia, the total amount of propofol usage was recorded. Patients were then followed up by telephone in the first, third, and sixth months after anesthesia, and the severity and frequency of the headache were recorded. Pain intensity or pain frequency significantly improved in 22 patients (43.1%), remained unchanged in 24 (47%), and worsened in 5 cases (9.8%) 6 months after anesthesia compared to before the anesthesia. In conclusion, since about half of the patients had significant improvement in the headache, propofol anesthesia may be considered as an acceptable anesthetic method in patients with migraine. 

Graphical Abstract

The Effect of Propofol Anesthesia on the Pain Severity and Frequency of Migraine Attacks in Patients with Chronic Migraine Headache over a Six Month Follow Up: An Observational Study

Keywords

References


(1) Burch RC, Buse DC and Lipton RB. Migraine:Epidemiology, Burden, and Comorbidity. Neurol.Clin. )2019( 37: 631-9.
(2) Wormald JCR, Luck J, Athwal B, Muelhberger Tand Mosahebi A. Surgical intervention for chronicmigraine headache: A systematic review. JPRASOpen )2019( 20: 1-18.
(3) Gupta VK. Pathophysiology of migraine: anincreasingly complex narrative to 2020. FutureNeurol. )2019( 14: 12-7.
(4) Krusz JC, Scott V and Belanger J. IntravenousPropofol: Unique Effectiveness in TreatingIntractable Migraine. J. Headache Pain )2000( 40:224–30.
(5) Orr SL, Aubé M, Becker WJ, Davenport WJ,Dilli E, Dodick D, Giammarco R, Gladstone J,Leroux E, Pim H, Dickinson G and Christie SN.Canadian Headache Society systematic review andrecommendations on the treatment of migrainepain in emergency settings. Cephalalgia )2015( 35:271-84.
(6) Orr SL, Friedman BW, Christie S, MinenMT, Bamford C, Kelley NE and Tepper D.Management of Adults With Acute Migraine in theEmergency Department: The American HeadacheSociety Evidence Assessment of ParenteralPharmacotherapies. Headache )2016( 56: 911-40.
(7) Kelly A. Propofol for migraine: Just because wecan, should we? Emerg. Med. Australas. )2019( 32:540–1.
(8) Soleimanpour H, Taheraghdam A, GhafouriRR, Taghizadieh A, Marjany K, SoleimanpourM. Improvement of refractory migraine headacheby propofol: case series. Int. J. Emerg. Med. )2012(5: 19.
(9) Piatka C and Beckett RD. Propofol for Treatmentof Acute Migraine in the Emergency Department:A Systematic Review. Acad. Emerg. Med. )2020(27: 148-60.
(10) Sheridan DC, Spiro DM, Nguyen T, Koch TK,Meckler GD. Low-dose propofol for the abortivetreatment of pediatric migraine in the emergencydepartment. Pediatr. Emerg. Care )2012( 28:1293–6.
(11) Giampetro D, Ruiz-Velasco V, Pruett A, WicklundM and Knipe R. The Effect of Propofol on ChronicHeadaches in Patients Undergoing Endoscopy.Pain Res. Manag. )2018( 15: 1–7.
(12) Headache Classification Committee of theInternational Headache Society (IHS). TheInternational Classification of Headache Disorders,3rd edition (beta version). Cephalalgia )2013( 33:629-808.
(13) Rau JC and Dodick DW. Other Preventive AntiMigraine Treatments: ACE Inhibitors, ARBs,Calcium Channel Blockers, Serotonin Antagonists,and NMDA Receptor Antagonists. Curr. TreatOptions Neurol. (2019) 21: 17-8.
(14) Hsing CH and Wang JJ. Clinical implication ofperioperative inflammatory cytokine alteration.Acta Anaesthesiol. Taiwan. )2015( 53: 23-28.
(15) Samir A, Gandreti N, Madhere M, Khan A, BrownM and Loomba V. Anti-inflammatory effects ofpropofol during cardiopulmonary bypass: A pilotstudy. Ann. Card. Anaesth. )2015( 18: 495-501.
(16) Mendes PM, Silberstein SD, Young W B, RozenTD and Paolone MF. Intravenous Propofol in theTreatment of Refractory Headache. J. HeadachePain )2002( 42: 638–41.
(17) Razavi S, Gharaei B, Jafari A, AghamohammadiH and Mirkheshti A. Propofol and Alfentanilin Treatment of a Patient with Episodic ClusterHeadache. Anesth. Pain Med. )2014( 4: 17560.
(18) Mohseni M and Fatehi F. Propofol alleviatesintractable migraine headache: a case report.Anesth. Pain Med. (2012) 2: 94–6.
(19) Moshtaghion H, Heiranizadeh N, RahimdelA, Esmaeili A, Hashemian H and Hekmati 421Effect of Propofol on Migrainemoghaddam S. The Efficacy of Propofol vs.Subcutaneous Sumatriptan for Treatment ofAcute Migraine Headaches in the EmergencyDepartment: A Double-Blinded Clinical Trial. PainPract. (2014( 15: 701–5.
(20) Sheridan DC, Hansen ML, Lin AL, Fu R andMeckler GD. Low-Dose Propofol for PediatricMigraine: A Prospective, Randomized ControlledTrial. J. Emerg. Med. )2018( 54: 600-6.
(21) Golfam P, Yari M, Rezaei M, Farhadi K, JafariRM and Lahoorpour A. The effect of intravenouspropofol on the incidence of post-dural punctureheadache following spinal anesthesia incesareansection. J. Kermanshah Univ. Med. Sci. )2016( 20:51-5.
(22) Botros JM, Sayed AM. Comparison between theEffects of Sumatriptan Versus Naratriptan in theTreatment of Postdural Puncture Headache inObstetric Patients: A Randomized Controlled Trial.Anesth Essays Res. (2019) 13: 376-82.
(23) Vosoughian M, Dabir Sh, Dahi M, Moshari M.Low-Dose Propofol for the Treatment of SeverePostpartum Post-Dural Puncture Headache: A CaseReport. Case Reports in Clinical Practice. (2021)6: 169-72.
Iranian Journal of Pharmaceutical Research
Volume 20, Issue 4
Autumn 2021
Pages 415-421

Files

Share

How to cite

Statistics