Almost three quarters of the patients were considered (25 of 34). Responders showed 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).
Ketamine Nasal Spray approved for treating depression is Esketamine. Critics are urging caution in it's use to to limited trials and evidence.
Self-Administered SPG Blocks can also treat anxiety and maybe depression utilizing only safe an anesthetic used commonly in medicine and dentistry, Lidocaine, a natural anti-inflammatory. In Greece studies have shown that SPG Blocks can eliminate about 1/3 of essential Hypertension cases. The blocks apparently turn off Sympathetic Overload and the Fight or Flight reflex and let the Parasympathetic reflexes dominate.
The use of prophylactic SPG Blocks may prevent many hospital admissions for pediatric migraine.
The Sphenopalatine Ganglion is the largest parasympathetic ganglion of the head and has sympathetic fibers arising the the sympathetic cervical chain pass thru it, including fibers from the Stellate Ganglion. The SPG also has somatosensory nerves that pass thru it.
There are a wide variety of patient videos discussing the use of self-administered SPG Blocks for many different issues and can be found searching Google for Self-Administered SPG Blocks and checking Video results.
Pediatr Neurol. 2020 Mar;104:46-53. doi: 10.1016/j.pediatrneurol.2019.10.007. Epub 2019 Nov 29.
Intranasal Ketamine for Abortive Migraine Therapy in Pediatric Patients: A Single-Center Review.
Ketamine has recently emerged as a promising therapeutic alternative for abortive migraine therapy, likely secondary to N-methyl-d-aspartate antagonism. Most reports examine adults and the intravenous route. Fewer utilize intranasal administration or pediatric populations. Given the limited evidence for intranasal ketamine in pediatric migraine populations, we retrospectively reviewed our experience to further characterize safety and efficacy of intranasal ketamine in this population.
A retrospective review in a free-standing, pediatric medical center was performed examining the utilization of intranasal ketamine at 0.1 to 0.2 mg/kg/dose up to five doses in pediatric migraineurs. Pain scores (scale = 0 to 10) were recorded at baseline and after each dose. Response was characterized as pain score reduction to 0 to -3 and/or reduction of at least 50%.
Twenty-five encounters (25 of 34; 73.5%) were responders (mean pain score reduction of -7.2 from admission to treatment completion). Overall pain reduction from admission to discharge in the entire study population was 66.1%. Side effects were mild and transient.
Our experience with intranasal ketamine has promising outcomes in both pain relief and side effect minimization. When other therapeutic options are unavailable, practitioners should consider intranasal ketamine.
Copyright © 2019 Elsevier Inc. All rights reserved.
Adolescents; Children; Efficacy; Headache; Ketamine; Migraine; NMDA antagonist; Treatment