In people diagnosed with acute non-traumatic headaches, both intravenous ketorolac and intranasal ketamine effectively decreased headaches. However, ketamine exhibited a slightly superior analgesic effect when compared to ketorolac, according to the findings of a randomized and double-blind clinical trial published in the journal “Head & Face Medicine”. Hooman Rafiei Sarvari et al. performed this study to compare the efficacy of intranasal ketamine (0.75 mg/kg, max 75 mg) and intravenous ketorolac (30 mg) for the management of acute non-traumatic headaches.

A total of 140 participants were segregated into two groups: (i) Group A (n=70): Received intranasal ketamine and (ii) Group B (n=70): Received intravenous ketorolac. Using Visual Analogue Scale (VAS), the severity of headache was assessed on arrival, 30, 60, and 120 min after treatment. Recording of adverse effects was done one hour post-treatment.

Regarding the mean difference of pain intensity 30, 60, and 120 minutes post-intervention, profound inter-group differences were noted. In the initial 30 minutes, substantial alterations were witnessed in the VAS levels of both groups. The intranasal ketamine group exhibited significantly greater alterations in comparison with the intravenous ketorolac group. Few adverse effects like dizziness, fatigue, discomfort, nausea, hypertension, increased heart rate were considerably higher in the ketamine group.

Thus, both intravenous ketorolac and intranasal ketamine yield satisfactory outcomes in people having acute non-traumatic headaches.