Intranasal ketamine effectively reduced pain in children with migraine from hospital admission to discharge. Findings from this single-center study were reported in Pediatric Neurology.

Researchers performed a retrospective review of the electronic medical records of pediatric patients with migraine who were cared for at the Cook Children’s Medical Center. A total of 34 children with migraine who received intranasal ketamine at 0.1 mg/kg/dose to 0.2 mg/kg/dose for up to 5 doses were included in the analysis. Baseline and post-dose pain scores were also assessed. Additionally, researchers evaluated patients’ responses to therapy, defined as a pain score reduction of 0 to -3 and/or reduction of ≥50% on a 10-point scale.

On average, responders and nonresponders received intranasal ketamine doses of 0.14 mg/kg/dose. Approximately 73.5% (n=25) of patients within the retrospective cohort were considered responders. From admission to the end of treatment, the group had a mean pain score reduction of -7.2. Responders also received a significantly lower mean total dose compared with nonresponders (30.2 mg vs 45.8 mg, respectively; P =.009).

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Overall, there was a 66.1% reduction in pain scores among responders and nonresponders (83.7% vs 16.6%, respectively). Significant differences were observed between the mean pain scores of responders and nonresponders immediately after ketamine dose 1 (5 vs 7.4, respectively; P =.0149), dose 2 (3.1 vs 7.3; P =.001), dose 3 (2.9 vs 7.1; P =.001), dose 4 (1.3 vs 7.4; P <.001), and dose 5 (2.3 vs 6.9; P =.009).

Limitations of this study included its retrospective design as well as the inclusion of a small number of pediatric patients from a single center.

Based on these findings, the researchers suggested that “practitioners should consider integration of intranasal ketamine into abortive migraine therapy algorithms.”

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Turner AL, Shandley S, Miller E, Perry MS, Ryals B. Intranasal ketamine for abortive migraine therapy in pediatric patients: a single-center review. Pediatr Neurol. 2020;104:46-53.

This article originally appeared on Neurology Advisor