Key clinical point: Intravenous (IV) ketorolac plus metoclopramide failed to improve pain intensity in children presenting to the emergency department (ED) for the acute treatment of migraine compared with metoclopramide monotherapy.
Major finding: The mean change in pain intensity as assessed by a 100 mm Visual Analog Scale at 120 minutes was −44 mm (95% CI 32-57 mm) in the monotherapy group and −36 mm (95% CI 23-49 mm) in the ketorolac group, corresponding to a mean difference of 8 mm between the groups ( P = .355), with no significant between-group difference in headache recurrence and adverse events.
Study details: Findings are from a double-blind, randomized placebo-controlled trial including 53 children aged 6-17 years presenting to the ED for the acute treatment of migraine. They were randomly assigned to receive IV ketorolac plus metoclopramide (n = 26) or IV metoclopramide plus placebo (n = 27).
Disclosures: This study was funded by the Canadian Institutes of Health Research through a Drug Safety and Effectiveness Network grant. The authors declared no conflicts of interest.
Source: Richer LP et al. A randomized trial of ketorolac and metoclopramide for migraine in the emergency department. Headache. 2022 ; 62: 681-689 (Jun 7). Doi: 10.1111/head.14307