Efficacy of ophthalmic tetracaine for acute migraine relief: A randomized, placebo-controlled trial in the emergency department
Abstract
Objectives: To assess the efficacy of ophthalmic tetracaine for treating migraine headaches in the emergency department (ED).
Methods: In this randomized, double-blind, placebo-controlled study, ninety patients were randomly assigned to two groups: ophthalmic tetracaine (0.5 mg/mL), vs placebo (artificial tear), both of which were administered by a blinded resident. Headache intensity was measured via a visual analog scale (VAS) before treatment and at 1-, 3-, and 5-minutes post-administration, with patients monitored for six hours for efficacy and side effects.
Results: Ninety patients were enrolled, with no significant baseline differences between groups. Mean pain scores were similar at baseline (8.80 ± 1.52 vs. 7.00 ± 2.43; P = 0.46) but were significantly lower in the tetracaine group at 1 min (5.28 ± 2.71 vs. 7.33 ± 2.46), 3 min (4.53 ± 3.53 vs. 7.31 ± 2.45), and 5 min (4.13 ± 3.20 vs. 7.28 ± 2.42) (all P < 0.001). Blurred vision (37.7% vs. 2.2%) and eye irritation (82.2% vs. 4.4%) were more frequent with tetracaine, while other adverse events were similar between groups.
Conclusions: Although ophthalmic tetracaine was associated with a rapid reduction in migraine pain intensity in this study, the findings should be interpreted cautiously given the small sample size, incomplete patient blinding, and short follow-up period. While these results suggest a potential role for tetracaine as an early adjunctive therapy in the emergency setting, further large-scale,…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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