Effectiveness of intravenous Dexamethasone versus Propofol for pain relief in the migraine headache: A prospective double blind randomized clinical trial

Background: There are many drugs recommended for pain relief in patients with migraine headache. Methods: In a prospective double blind randomized clinical trial, 90 patients (age >= 18) presenting to Emergency medicine Department with Migraine headache were enrolled in two equal groups. We used intravenous propofol (10 mg every 5-10 minutes to a maximum of 80 mg, slowly) and intravenous dexamethasone (0.15 mg/kg to a maximum of 16 mg, slowly), in group I and II, respectively. Pain explained by patients, based on VAS (Visual Analogue Scale) was recorded at the time of entrance to ED, and after injection. Data were analyzed by paired samples t test, using SPSS 16. P < 0.05 was considered to be statistically significant. Results: The mean of reported pain (VAS) was 8 +/- 1.52 in propofol group and 8.11 +/- 1.31 in dexamethasone group at presenting time (P > 0.05). The VAS in propofol group was obviously decreased to 3.08 +/- 1.7, 1.87 +/- 1.28 and 1.44 +/- 1.63 after 10, 20 and 30 minutes of drug injection, respectively. The VAS in dexamethasone group was 5.13 +/- 1.47, 3.73 +/- 1.81 and 3.06 +/- 2 after 10, 20 and 30 minutes of drug injection, respectively. The mean of reported VAS in propofol group was less than dexamethasone group at the above mentioned times (P < 0.05). The reduction of headache in propofol group, also, was very faster than dexamethasone group (P < 0.05). There were no adverse side effects due to administration of both drugs. Conclusions: Intravenous propofol is an efficacious and safe treatment for patients presenting with Migraine headache to the emergency department.