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Intravenous Fluid for Pediatric Migraine in the Emergency Department

Phase 1
Completed
Conditions
Migraine
Headache
Interventions
Drug: Normal saline
Registration Number
NCT01073787
Lead Sponsor
University of Alberta
Brief Summary

The purpose of this study is to evaluate the effect of intravenous fluid (0.9% sodium chloride and water) alone on headache pain in children with migraine visiting the Emergency Department.

Detailed Description

Migraine is a common and disabling disorder for children. The pain may be severe and relatively few effective medications are approved for use in children. The Emergency Department (ED) remains an important resource for children suffering from migraine whom have not responded to their usual therapy. While a number of effective intravenous therapies have been studied in adults, there has been only one such study in children. As such, emergency physicians have little or no information about the safety and efficacy of these medications in children. However, the conduct of clinical trials where pain is the outcome measure is often limited by a high placebo-response rate. The expectation of treatment can significantly alter the response to medications especially when pain severity is the outcome measure. Moreover, the investigators have found that intravenous fluid alone may help to treat migraine headache in children. The investigators propose a study to examine the response to intravenous fluid hydration as initial therapy comparing a group with expectation of medication and another group without the initial expectation of medication. The results of the study will help to estimate the rate of response to intravenous fluid and to evaluate the placebo-effect (i.e. expectation of treatment) in studies of migraine treatment in the ED. Exposure to additional and possibly unnecessary medications will thus be minimized and the results of future trials more definitive on the effect of the study medication.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
46
Inclusion Criteria
  • Diagnosis of migraine or probable migraine (with or without aura) per the International Classification of Headache Disorders (2nd edition)
  • Visiting the Emergency Department for migraine treatment
  • Emergency Department physician has chosen to administer intravenous medication
  • Has taken usual therapy at home or at least one does of either ibuprofen or acetaminophen in the Emergency Department
Exclusion Criteria
  • Other probable cause for headache (e.g. ventriculoperitoneal shunt, neoplasm, intracranial cyst)
  • Head trauma causing loss of consciousness within 1 week of presentation
  • Fever (temperature > 38.5 oC)
  • Signs or symptoms of meningitis

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Normal salineNormal saline-
Normal saline and possible medicationNormal saline-
Primary Outcome Measures
NameTimeMethod
Headache pain30 minutes

Pain will be assessed using three measures: (1) Nine Faces Pain scale; (2) Visual Analogue Scale; and (3) Four categories (none, mild, moderate, or severe)

Secondary Outcome Measures
NameTimeMethod
Headache recurrence24 hours

Recurrence or worsening of headache after leaving the Emergency Department

Nausea30 minutes

Severity will be assessed using: (1) Visual Analogue Scale; (2) Four categories (none, mild, moderate, severe)

Use of rescue medication24 hours

Use of any rescue medication after leaving the Emergency Department

Return to Emergency Department24 hours

Return to Emergency Department for treatment of migraine within 24 hours

Vomiting30 minutes

Trial Locations

Locations (1)

Stollery Children's Hospital Emergency Department

🇨🇦

Edmonton, Alberta, Canada

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