Anesthetic jab treats headache in the ED

NEW YORK (Reuters Health) - For patients suffering severe headaches who present to the emergency department, the painkiller bupivacaine injected into the muscles at the base of the neck provides safe and effective headache relief.

These are the findings of a look back at all 417 headache patients, 18 years of age or older, who received this treatment over a 1-year period at a single emergency department.

Complete headache relief occurred in 65 percent and partial headache occurred in 20 percent of patients. Roughly 14 percent reported no significant headache relief and 1 percent reported a worsening of headache pain.

Overall, bupivacaine injections yielded a therapeutic response in 356 of 417 patients (85.4 percent), report Dr. Larry B. Mellick of the Medical College of Georgia in Augusta and colleagues in the journal Headache.

"Headache relief was typically rapid with many patients reporting complete headache relief in 5 to 10 minutes," the authors note. Headache relief was often accompanied by resolution of associated signs and symptoms such as nausea, vomiting, and sensitivity to sound and light.

Mellick and colleagues note that headache is a "common chief complaint" of patients who present to the emergency department. Many come to the ED as a last resort after other interventions have failed to provide headache relief.

Based on their experience, the authors say bupivacaine injection "appears to be a safe and effective therapeutic intervention for the treatment of headache pain caused by a spectrum of etiologies presenting to the ED setting."

SOURCE: Headache, October 2006.