The Effect of Butyrophenones for the Management of Primary Headache in the Emergency Department: A Systematic Review and Meta-Analysis
Journal Title: The Journal of Medicine, Law & Public Health (JMLPH) - Year 2023, Vol 3, Issue 2
Abstract
BACKGROUND: The use of butyrophenones for headaches became plausible when the association was established between dopamine and headache. However, despite their positive effect on acute headaches, their use remains controversial. AIM: The goal of this study is to ascertain whether the addition of haloperidol or droperidol to the treatment regimen for acute primary headache lowers the pain score of adult patients in the emergency department. METHODS: A systematic review and meta-analysis was conducted. We searched the following databases for randomised controlled trials (RCTs): PubMed, Cochrane databases, and grey literature, from 1963 to October 2022. Included were RCTs conducted on the use of butyrophenones (IV haloperidol or IV/IM droperidol) in the acute management of primary headaches (diagnosed or undiagnosed), designated prospective, double-blind or open, using only the Visual Analogue Scale (VAS) with a specific measurement time. We excluded non-English studies that lacked translation, studies conducted on paediatric age groups, and studies conducted on animals. RESULTS: Out of 49 articles we included seven, three of which investigated haloperidol. The mean difference in VAS score favoured haloperidol; -2.46 (95% CI: [-4.11 to -0.81]), indicating a drop in VAS score of 2.5/10 units. The mean difference in VAS score for the use of droperidol was -0.35 (95% CI: [-1.24 to 0.54]). CONCLUSION: Haloperidol can induce an acute 25% reduction in VAS score when added to the regimen for acute headache management. It also reduces the need for rescue medications and improves patient satisfaction. Nonetheless, considerable side effects cannot be overlooked.
Authors and Affiliations
Ahmed Alsuliamani, Rizq badawi, Erich Hanel, Sharafaldeen Bin Nafisah
Avoiding Medication Errors Caused by Nurses in the Emergency Department in Saudi Arabia
Background: Medication errors are pervasive in healthcare, especially in emergency rooms, with diverse causes that warrant critical investigation due to the potential repercussions for both patients and healthcare provid...
Adjudication and Treatment of Narcotic Drug Offenders in Ghana
Narcotic drug trafficking is a criminal and punishable offence in every country the world over. The use of certain narcotic drugs, on the other hand (especially marijuana), has been legalised in some countries, but under...
Renal Cell Carcinoma Migrating to the Right Atrium through the Inferior Vena Cava, need abstract)
A 63-year-old man with known type 2 diabetes mellitus, hypertension, and dyslipidemia was re-ferred to us from another hospital due to a right renal mass with inferior vena cava (IVC) extension. Three months...
Sleep Disturbance During Quarantine in the Era of the SARS-CoV-2 (COVID-19) Pandemic
Background Quarantine has been shown to affect sleep quality in previous analyses. However, a thorough investigation of the association between sleep disturbance and COVID-19 infection during quarantine is still lacking....
Disaster Cluster Approach: A Study of A New Model of Disaster Response
Background The current models of disaster response focus on international collaborations and assistance. However, little is known about the Saudi health cluster's disaster preparedness and response model. Aim Th...