Low- Dose Propofol Infusion as an Abortive Treatment for Migraine Headaches in Pediatric Patients (Propofol2014)
Primary Purpose
Migraine Headache
Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Propofol
Sponsored by
About this trial
This is an interventional treatment trial for Migraine Headache
Eligibility Criteria
Inclusion Criteria:
- Patients with a diagnosis of migraine headache per ICHD - 3 (International Classification of Headache Disorders)
- The subjects will have a history of migraine headaches with a presentation consistent with presentations of their headaches in the past with no indication for further investigation for secondary causes of his/her headache
- Documented pain score greater than or equal to 6 on a 0-10 Numeric Pain Rating Scale
- Current migraine has a greater than 24 hours duration with a current pain score of 6 or greater on a 0-10 Numeric Pain Rating Scale
- Subjects will be scheduled for DHE infusion therapy for treatment of migraines per standard medical care
- Patients age 7-18 years old
- Gender: both male and female
- Appropriate fasting interval as per ASA guidelines
Exclusion Criteria:
- No long acting triptan therapy within 24 hours
- No shorter acting triptan therapy within 6 hours
- No ergot alkaloid derivatives within the last 24 hours
- No opioid within 2 hours
- No NSAID or acetaminophen within 1 hour of infusion
- Use of sedative medications within 6 hours of infusion, including opioids, benzodiazepines, barbiturates
- Headache not consistent with subject's headache history needing further work-up
- Headache duration less than 24 hours
- Subjects in which an intravenous line could not be secured
- Subjects with history of significant reflux or hiatal hernia
- Subjects with history of significant cardio pulmonary disorders
- Patient not fasting as per ASA guidelines
Sites / Locations
- Children's Health Children's Medical Center Dallas
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Propofol infusion
Arm Description
All subjects will be treated with an intravenous propofol infusion at the following escalating rate schedule: 20 mcg/kg/min for 10 minutes, followed by an increase to 30 mcg/kg/min for 10 minutes and then by an increase to 40 mcg/kg/min for 40 minutes
Outcomes
Primary Outcome Measures
Improvement in Headache Pain Score
Reduction in pain score on 0-10 Numeric Pain Rating Scale. Subjects assessed at 5 minute intervals for the duration of the infusion
Secondary Outcome Measures
Duration of analgesia
For subjects who experience improvement in pain score or who report resolution from headache symptoms, duration of analgesia up to 48 hours after treatment,characterized by NPRS Pain scores.
Total propofol dose
Total dose of propofol administered (mg/kg)
Full Information
NCT ID
NCT02485418
First Posted
June 4, 2015
Last Updated
August 29, 2023
Sponsor
University of Texas Southwestern Medical Center
1. Study Identification
Unique Protocol Identification Number
NCT02485418
Brief Title
Low- Dose Propofol Infusion as an Abortive Treatment for Migraine Headaches in Pediatric Patients
Acronym
Propofol2014
Official Title
Low- Dose Propofol Infusion as an Abortive Treatment for Migraine Headaches in Pediatric Patients
Study Type
Interventional
2. Study Status
Record Verification Date
August 2023
Overall Recruitment Status
Completed
Study Start Date
June 2015 (Actual)
Primary Completion Date
January 24, 2023 (Actual)
Study Completion Date
January 24, 2023 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Texas Southwestern Medical Center
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
Propofol has been used in adult populations to treat migraines as an abortive agent. Investigators plan to investigate its efficacy as an abortive agent in the pediatric population when administered as a safe low-dose infusion. Goals of the study are to:
Evaluate efficacy of low-dose propofol infusion as an abortive agent in pediatric migraine headaches
Evaluate effective and safe dosing limits in pediatric populations
Evaluate duration of effect reached from a low-dose propofol infusion as an abortive agent
Endpoints for the study will be:
Number of enrolled patients
Safety endpoints reached, including: cardiopulmonary depression, excessive somnolence Risks of the study are minimal due to the use of sub-anesthetic dosing of propofol under the guidance and supervision of a board certified pediatric anesthesiologist with the appropriate monitoring equipment and readily available emergency equipment. Investigators hope to demonstrate more rapid improvement and decreased side-effect as compared to standard care.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Migraine Headache
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
40 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Propofol infusion
Arm Type
Experimental
Arm Description
All subjects will be treated with an intravenous propofol infusion at the following escalating rate schedule:
20 mcg/kg/min for 10 minutes, followed by an increase to 30 mcg/kg/min for 10 minutes and then by an increase to 40 mcg/kg/min for 40 minutes
Intervention Type
Drug
Intervention Name(s)
Propofol
Intervention Description
Intravenous propofol infusion at 20 mcg/kg/min for 10 minutes, followed by an increase to 30 mcg/kg/min for 10 minutes and then by an increase to 40 mcg/kg/min for 40 minutes.
Primary Outcome Measure Information:
Title
Improvement in Headache Pain Score
Description
Reduction in pain score on 0-10 Numeric Pain Rating Scale. Subjects assessed at 5 minute intervals for the duration of the infusion
Time Frame
Duration of propofol infusion (between 5 and 60 minutes)
Secondary Outcome Measure Information:
Title
Duration of analgesia
Description
For subjects who experience improvement in pain score or who report resolution from headache symptoms, duration of analgesia up to 48 hours after treatment,characterized by NPRS Pain scores.
Time Frame
Assessments at 10 minute intervals from the start of infusion while on site, and at 24 and 48 hours after discharge, up to 72 hours.
Title
Total propofol dose
Description
Total dose of propofol administered (mg/kg)
Time Frame
60 minutes
10. Eligibility
Sex
All
Minimum Age & Unit of Time
7 Years
Maximum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patients with a diagnosis of migraine headache per ICHD - 3 (International Classification of Headache Disorders)
The subjects will have a history of migraine headaches with a presentation consistent with presentations of their headaches in the past with no indication for further investigation for secondary causes of his/her headache
Documented pain score greater than or equal to 6 on a 0-10 Numeric Pain Rating Scale
Current migraine has a greater than 24 hours duration with a current pain score of 6 or greater on a 0-10 Numeric Pain Rating Scale
Subjects will be scheduled for DHE infusion therapy for treatment of migraines per standard medical care
Patients age 7-18 years old
Gender: both male and female
Appropriate fasting interval as per ASA guidelines
Exclusion Criteria:
No long acting triptan therapy within 24 hours
No shorter acting triptan therapy within 6 hours
No ergot alkaloid derivatives within the last 24 hours
No opioid within 2 hours
No NSAID or acetaminophen within 1 hour of infusion
Use of sedative medications within 6 hours of infusion, including opioids, benzodiazepines, barbiturates
Headache not consistent with subject's headache history needing further work-up
Headache duration less than 24 hours
Subjects in which an intravenous line could not be secured
Subjects with history of significant reflux or hiatal hernia
Subjects with history of significant cardio pulmonary disorders
Patient not fasting as per ASA guidelines
Facility Information:
Facility Name
Children's Health Children's Medical Center Dallas
City
Dallas
State/Province
Texas
ZIP/Postal Code
75235
Country
United States
12. IPD Sharing Statement
Learn more about this trial
Low- Dose Propofol Infusion as an Abortive Treatment for Migraine Headaches in Pediatric Patients
We'll reach out to this number within 24 hrs