In the emergency department, intravenously given lidocaine can be an alternative therapy for people suffering from migraine attack headaches.

A prospective, double-blind, randomized study was performed for exploring the impact of lidocaine infusion vs. non-steroidal anti-inflammatory drug (NSAID) to treat migraine attack headaches.

The study enrolled 100 migraine participants (age 18-65). They were randomly segregated into (i) Lidocaine group (n = 50): Subjects were administered lidocaine bolus (1.5 mg/kg) and 1 mg/kg infusion (initial 30 minutes), followed by a 0.5 mg/kg infusion for an additional 30 minutes intravenously, and (ii) NSAID group (n = 50): Subjects were administered dexketoprofen trometamol (50 mg) and saline at the similar volume as the lidocaine at the similar time intervals intravenously.

Recording of visual analog scale (VAS) pain scores, adverse effects, additional analgesia need, and revisits to the emergency department was done.

For the initial 20 and 30 minutes, the lidocaine group exhibited considerably reduced VAS pain scores when compared to the NSAID group. However, for the remaining assessment times, no difference was noted between the VAS pain scores.

Considering secondary endpoints, the need for rescue medication was not distinct between the two groups at both 60 and 90 minutes. But, the number of people revisiting the emergency department within 48-72 hours was substantially less in the lidocaine group (1/50) when compared to the NSAID group (8/50).

Intravenous lidocaine infusion is beneficial to alleviate migraine attacks in the emergency department.