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Migraine Treatment in Emergency Departments of Brazil: A Retrospective Study of 2 Regions
Author(s) -
Krymchantowski Abouch,
Jevoux Carla,
SilvaNéto Raimundo Pereira,
Krymchantowski Ana Gabriela
Publication year - 2020
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/head.13999
Subject(s) - medicine , sumatriptan , migraine , metoclopramide , metamizole , retrospective cohort study , ketorolac , anesthesia , emergency department , nonsteroidal , observational study , medical prescription , diclofenac , analgesic , migraine treatment , emergency medicine , receptor , psychiatry , pharmacology , vomiting , agonist
Objective This study describes the approaches, medications used, and time of care for migraineurs, who have been in emergency departments (ED) from 2 different regions of Brazil. Methods Retrospective, cross‐sectional, observational, non‐randomized study of migraine patients seen at 2 headache centers in Brazil. Results Eighty‐four migraine patients (15 men and 69 women) were divided into 2 groups: chronic (19%, n = 16) and episodic migraineurs (81%, n = 68). In the ED, medications were used in the following order of frequency: dipyrone or metamizole (89.3%, 75/84), nonsteroidal anti‐inflammatory drugs (57.1%; 48/84) opioids (51.1%; 43/84), metoclopramide (29.8%; 25/84), dexamethasone (28.6%; 24/84), chlorpromazine (13.1%; 11/84), and subcutaneous sumatriptan (7.1%; 6/84). The average time in the care center was 8.2 hours, but only 23 patients (27.4%) left the hospital with greater than 50% relief in headache severity. Conclusions Dipyrone and nonsteroidal anti‐inflammatories were the most used drugs, but nearly half received opioids. More efficient drugs were poorly used. Considering the number of patients leaving the hospital with headache relief, a changing treatment paradigm should be carried out in Brazil.