TREATMENT OF ACUTE HEADACHES AND CHRONIC PAIN USING RAPIDLY-CLEARED ANESTHETIC DRUG AT SUB-ANESTHETIC DOSAGES

摘要

A rapidly-cleared anesthetic drug such as propofol can be used to treat migraine or cluster headaches and other 'runaway pain' conditions. When used at a sub-anesthetic dosage level that does not cause a loss of consciousness, propofol (a drug used in surgical anesthesia, which is normally injected but which also can be inhaled) induces a feeling of sedated relaxation. This sedated relaxed condition can interrupt and stop a 'runaway pain' condition such as a migraine or cluster headache, as well as various types of intractable chronic pain, such as trigeminal facial pain or arachnoiditis. Typical treatments have used about 2 to 3 ml initially, followed by additional 2-3 ml boluses at timed intervals, depending on the pain status reported by the patient. When a desired level of sedation is reached and the patient reports that the pain is gone, the drug is terminated. It should be rapidly metabolized and eliminated from the blood, so that patients can recover quickly to an alert and functioning state (usually within 10 to 15 minutes, when propofol is used) and can safely drive away from a clinic and return to work or other normal activities, with no unpleasant side-effects or lingering after-effects. In tests on patients suffering acute migraine or cluster headaches or early-onset symptoms of cluster headache, most patients reported 100% relief with no problems of rebound headache the following day. In patients treated for chronic intractable pain, propofol treatment usually provided effective pain relief for about 3 to 5 days before another treatment was needed.