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Intravenous lidocaine vs. NSAIDs for migraine attack in the ED: a prospective, randomized, double-blind study

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Although different forms of lidocaine are used for migraine attack headaches, the effect of intravenous lidocaine is still limited. This study aimed to investigate the effects of intravenous lidocaine infusion for the treatment of migraine attack headaches.


A hundred patients with migraine attacks, aged between 18 and 65, were randomly divided into two groups. The lidocaine group (n = 50) received a 1.5 mg/kg lidocaine bolus and a 1 mg/kg infusion (first 30 min), followed by a 0.5 mg/kg infusion for a further 30 min intravenously. The non-steroidal anti-inflammatory drug (NSAID) group (n = 50) received 50 mg dexketoprofen trometamol and saline at the same volume as the lidocaine at the same time intervals intravenously. The Visual Analog Scale (VAS) pain scores, additional analgesia requirement, side effects, and revisits to the emergency department were recorded.


The VAS score was significantly lower in the lidocaine group than in the NSAID group for the first 20th and 30th minutes (p = 0.014 and p = 0.024, respectively). There was no difference between the VAS scores for the remaining evaluation times (p > 0.05). In terms of secondary outcomes, rescue medication requirement was not different between the two groups at both the 60th and 90th minutes (p > 0.05). However, the number of patients revisiting ED within 48–72 h was statistically less in the lidocaine group than in the NSAID group (1/50 vs. 8/50; p = 0.031).


Intravenous lidocaine may be an alternative treatment method for patients with migraine attack headaches in the emergency department.

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Authors and Affiliations



ST Akgol Gur, EO Ahiskalioglu: Planning, data collection, sample analysis, writing the first draft, evaluating and modifying the final manuscript. ME Aydin, AO Kocak: Data collection and evaluating subsequent drafts and the final manuscript. P. Aydin: Sample analysis, writing and the final manuscript. A. Ahiskalioglu: Writing and the final manuscript, supervisor.

Corresponding author

Correspondence to Elif Oral Ahiskalioglu.

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Ethic approval and patient consent

This study was conducted at the Ataturk University Faculty of Medicine, Erzurum, Turkey. It was approved by the local ethics board approval (B30.2ATA.0.01.00/462) and followed the Helsinki statement, and signed consent was obtained from all participants before the experiment.

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The authors declare no competing interests.

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Gur, S.T.A., Ahiskalioglu, E.O., Aydin, M.E. et al. Intravenous lidocaine vs. NSAIDs for migraine attack in the ED: a prospective, randomized, double-blind study. Eur J Clin Pharmacol 78, 27–33 (2022).

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