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Headaches are common in the ED department, making up for approximately 2% of ED visits. Primary Headache Disorder includes migraine, tension headaches, and trigeminal autonomic cephalgias (TACS). That’s up to 1.2 million patients walking in the Emergency Department to have their debilitating headache treated a year.

Current treatment recommendations are effective but not as immediate in giving pain relief as ideal.  Peripheral nerve blocks (i.e. dripping lidocaine into the nose) have shown to be fast and effective in small studies to provide pain relief in headaches, but the question is…how fast?

Read the latest evidence based, peer-reviewed treatment recommendations for migraines in PEPID’s Emergency Medicine Suite. Start a trial to access at the point of care.

Researchers reviewed eleven studies, and found pain scores were significantly lower in patients treated with peripheral nerve blocks than with placebo at 15 minutes, and 30 minutes without any serious adverse events. This study, however, was not able to compare peripheral nerve blocks with the latest therapy recommendations.

Emergency physicians may consider this a quick, easy to perform, cheap, and minimal risk practice to treat primary headache disorders.


E;, B. R. E. (n.d.). Primary headache disorders. Dental clinics of North America. Retrieved November 10, 2021, from https://pubmed.ncbi.nlm.nih.gov/23809307/.

Patel, D., Yadav, K., Taljaard, M., Shorr, R., & Perry, J. J. (2021, October 28). Effectiveness of Peripheral Nerve Blocks for the Treatment of Primary Headache Disorders: A Systematic Review and Meta-Analysis. Annals of Emergency Medicine. Retrieved November 10, 2021, from https://www.annemergmed.com/article/S0196-0644(21)00794-0/fulltext.

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