Propofol for the Treatment of Migraine Headache in the Emergency Department?

Emergency department (ED) treatment of migraine headache varies by clinician and may include a variety of medications, such as nonsteroidal analgesics, dopamine antagonists (e.g., metoclopramide, prochlorperazine, haloperidol/droperidol), and even antiepileptics and steroids. Subanesthetic-dose propofol has been suggested as another modality for ED treatment of migraines.

Researchers reviewed the literature on ED use of propofol for migraines and identified nine studies, which included 290 patients. Only three studies were randomized trials. Dosing of propofol varied widely, from weight-based (0.25–1 mg/kg) to fixed-bolus (10–60 mg, repeated as needed). Overall, use of propofol reduced pain scores and, in some cases, reduced rebound headache…