Migraine treatment with….propofol?

http://academiclifeinem.com/on-the-horizon-propofol-for-migraines/                              Image

The link above shows a summary of a few studies showing some effectiveness for propofol in treatment of migraines..

An interesting idea, with apparently a decent amount of evidence behind it.  I’ve always been curious about trying it with some of our chronic migraine patients, but I have not used it.  Has anyone had any experience with this?

Also, I’m curious whether people have a certain “migraine cocktail” they prefer using.  Please post in the comments section.

Also don’t forget to vote in the poll!

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4 thoughts on “Migraine treatment with….propofol?

  1. My preference has always been a combination of droperidol and benadryl, and sometimes I will add a small amount of decadron to this cocktail. with the shortage of droperidol, sometimes I will just substitute 2 or 2.5 mg of haloperidol. I remember reading literature back during my residency that IV compazine is first line treatment for migraines, but we seem to rarely have that drug available as well. Somtimes I will also use Reglan, benadryl, and toradol (if I am not concerned about the possibility of a head bleed). I feel that the droperidol and benadryl combination has given me the most success. What medications have you all had the most success with?

    • Additionally, I will sometimes do a cervical injection I refer to as the “Mellick Block.” I think this is a valuable option for some of our chronic migraine patients, although I have only had mixed success with it. Here is a little YouTube video by Dr. Mellick that goes through the step by step process of this technique. Has anyone else used this in their practice? It’s quick, and if anyone has questions or would like to try this technique, I would be more than happy to show you. It is also supposed to be effective for chronic orofacial pain, but I have not used it for that indication before.

  2. I have used toradol, benadryl, fluids and zofran. sometimes decadron if the headache is better, but not gone and sometimes fentanyl if nothing works.

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