intranasal lidocaine for primary headache management in emergency department; a clinical trial

Introduction: most of the headache cases only require pain management in emergency department (ed). the present study aimed to evaluate the efficacy of intranasal lidocaine in this regard. methods: in this clinical trial, adult patients with primary headache were randomly treated with 7.5 mg intravenous (iv) chlorpromazine and 1 ml intranasal lidocaine 2% (treatment) or normal saline 0.9% (placebo), and were compared 5, 15, and 30 minutes later regarding success rate using spss 21. results: 100 patients were assigned to either treatment or placebo group. number needed to treat of intranasal lidocaine at 5, 15, and 30 minutes were 4 (95% ci: 2.2 – 6.6), 3 (95% ci: 1.7 – 3.5), and 4 (95% ci: 2.3 – 15.9), respectively. these measures for absolute risk reduction were 30 (95% ci: 15.2 – 44.8), 44 (95% ci: 28.7 – 59.3), and 26 percent (95% ci: 6.3 – 44.3), respectively. pain relapse occurred in 16% of treatment and 11% of control group within 1 hour of treatment (p = 0.402). conclusion: it seems that, intranasal lidocaine along with iv chlorpromazine could result in more successful and faster management of primary headaches in ed.