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Intravenous magnesium sulfate to treat acute headaches in the emergency department: A systematic review

Headache: The Journal of Head and Face Pain Oct 12, 2019

Miller AC, Pfeffer BK, Lawson MR, et al. - Via performing a systematic review, researchers sought to investigate if patients with non-traumatic headaches (Population) show better pain control, lower rate of recurrence at 24 hours, lower requirements for rescue analgesia, and less adverse medication effects (Outcomes) on receiving intravenous magnesium sulfate (Intervention) vs placebo, corticosteroids, dopamine antagonists, ergot alkaloids, non-steroidal anti-inflammatory drugs, triptans, or usual care. Searching scholarly databases and relevant bibliographies, they identified 4,018 references; of these, 7 randomized clinical trials (545 participants) that treated migraine headaches (n = 6) and benign non-traumatic headaches (n = 1) were included. Based on evidence gained, no firm conclusion on the efficacy or benefit of intravenous magnesium sulfate in the treatment of acute non-traumatic headaches was made, however, it seems to have the potential for improving pain control beyond 1 hour, aura duration, and need for rescue analgesia. Magnesium sulfate vs comparators was identified resulting in an improvement in pain intensity at 60-120 minutes, but not at earlier time points.
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