Abstract, presented at PaACEP 1998:

Brenda Oatman, M.D., York Hospital/Penn State Univ. EM Residency
A prospective, randomized, double-blind comparison of IV MgSO4 and IV
prochlorperazine in the treatment of acute headache.

OBJECTIVE: Previous uncontrolled, non-randomized trials suggest that magnesium
sulfate is effective in treatment of headache. The objective of this study was
to determine the efficacy of IV MgS04 versus prochlorperazine (PRO) in the
treatment of acute headache.

METHODS:
Design: Prospective, randomized, double-blind trial.
Setting: 55,000 visit community teaching hospital ED.
Participants: Patients ages 18 to 50, presenting to the ED with chief
complaint of headache, excluding pregnant females, patients with known adverse
reaction to the study drugs, and patients with serious medical disease.
Intervention: Patients rated their pain on a visual analog scale prior to and
30 minutes after study drug infusion. Each was randomly assigned either 2
grams MgS04 or 10 mg. PRO IV.

RESULTS: 36 patients were enrolled; 20 received PRO, 16 received MqS04. The
groups were similar with regard to gender, duration of headache, and
medications taken prior to ED arrival. There was complete or partial pain
relief in 90% (18/20) of the PRO group and 56% (9/16) of the MgS04 group. The
difference was statistically significant using Chi Square analysis (p<.04).
Mean pain reduction, as evaluated by the visual analog scale, was 4.8 cm. for
PRO and 2.4 cm. for MgS04 by t test (p<.05) with 95% CI (0.056, 4.694). PRO
caused fewer adverse effects (p<.05).

CONCLUSIONS: IV PRO is highly effective in treatment of headache and
significantly better than IV magnesium, with fewer adverse effects.