Sedative Dosing of Propofol for Treatment of Migraine Headache in the Emergency Department: A Case Series
A 51-year-old male with past medical history of migraines, hypertension and depression presented with headache for the previous 24 hours. The pattern was typical of his migraine headaches. Initial vital signs were heart rate 97, blood pressure 135/93, respiratory rate 16 and pain scale of 9/10. His migraine had not responded to his home medications. Prior migraines requiring ED visits were treated with: prochlorperazine, diphenhydramine, acetaminophen, droperidol, ibuprofen, morphine, and normal saline. Physical exam was unremarkable for any focal neurologic findings other than photophobia.\nThe patient was consented for procedural sedation and treated with 1 mg/kg of propofol. Thirteen minutes after medication the patient was arousable. The patient was observed for an additional 1 hour and 9 minutes during which the headache decreased to 2/10 and then complete resolution with no further pharmacologic intervention. He was reassessed and discharged home with a total LOS of 2 hours. Discharge vital signs were heart rate 77, blood pressure 137/94, respiratory rate 16.