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Some data suggest that intranasal lidocaine provides relief in about half of patients -- presumably by affecting the sphenopalatine ganglion. This prospective, randomized, double-blind, placebo-controlled trial enrolled 81 urgent care patients with a chief complaint of headache who met clinical criteria for migraines. None had headaches more than once per week or longer than three days.
Two-thirds of the patients received a 4 percent lidocaine solution instilled after the onset of migraine: 0.5 ml was dripped into the nostril over 30 seconds while they lay supine with their heads rotated toward the side of the headache. For bilateral headaches, bilateral administration was used. The patients received repeat doses if their headache persisted …