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En el mundo actual, donde el tiempo de atención se encuentra limitado y las tecnologías intentan reemplazar la figura del médico en pos de una atención mecanizada; muchos pacientes se encuentran a la deriva, llenos de dudas y ansiedad que persiste a pesar de la gran cantidad de estudios a los que fueron sometidos.







Este blog tiene como objeto recuperar ese tiempo perdido...intentaremos responder científica y humanamente las preguntas de pacientes y, por qué no, la de médicos que quieren una segunda opinión.







La idea es encaminar a los enfermos o a sus familiares, acercándoles un abanico de posibilidades diagnósticas, en función de sus síntomas y exámenes complementarios si los tuviesen y, de ser posible, plantear estrategias de tratamiento.







A los médicos acercar información actualizada o simplemente compartir experiencias neurológicas para enriquecer nuestra actividad a partir del intercambio de ideas.







Queda asi planteado nuestro objetivo .



Muchas gracias a todos los interesados.















José Santiago Bestoso







médico neurólogo.























martes, 29 de enero de 2013

Effectiveness of Intravenous Dexamethasone versus Propofol for Pain Relief in the Migraine Headache


Effectiveness of Intravenous Dexamethasone versus Propofol for Pain Relief in the Migraine Headache

A Prospective Double Blind Randomized Clinical Trial

Hassan Soleimanpour, Rouzbeh R Ghafouri, Aliakbar Taheraghdam, Dawood Aghamohammadi, Sohrab Negargar, Samad EJ Golzari, Mohsen Abbasnezhad
Disclosures
BMC Neurol. 2012;12(114) 
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Abstract

Background There are many drugs recommended for pain relief in patients with migraine headache.
Methods In a prospective double blind randomized clinical trial, 90 patients (age ≥ 18) presenting to Emergency medicine Department with Migraine headache were enrolled in two equal groups. We used intravenous propofol (10 mg every 5–10 minutes to a maximum of 80 mg, slowly) and intravenous dexamethasone (0.15 mg/kg to a maximum of 16 mg, slowly), in group I and II, respectively. Pain explained by patients, based on VAS (Visual Analogue Scale) was recorded at the time of entrance to ED, and after injection. Data were analyzed by paired samples t test, using SPSS 16. P < 0.05 was considered to be statistically significant.
Results The mean of reported pain (VAS) was 8 ± 1.52 in propofol group and 8.11 ± 1.31 in dexamethasone group at presenting time (P > 0.05). The VAS in propofol group was obviously decreased to 3.08 ± 1.7, 1.87 ± 1.28 and 1.44 ± 1.63 after 10, 20 and 30 minutes of drug injection, respectively. The VAS in dexamethasone group was 5.13 ± 1.47, 3.73 ± 1.81 and 3.06 ± 2 after 10, 20 and 30 minutes of drug injection, respectively. The mean of reported VAS in propofol group was less than dexamethasone group at the above mentioned times (P < 0.05). The reduction of headache in propofol group, also, was very faster than dexamethasone group (P < 0.05). There were no adverse side effects due to administration of both drugs.
Conclusions Intravenous propofol is an efficacious and safe treatment for patients presenting with Migraine headache to the emergency department.

Trial registration Clinical Trials IRCT201008122496N4
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