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Type: Artigo de periódico
Title: Treatment Of Status Migrainosus By General Anesthesia: A Case Report.
Author: Udelsmann, Artur
Saccomani, Priscila
Dreyer, Elisabeth
da Costa, Alberto Luiz Cunha
Abstract: The status migrainosus is a complication of migraine characterized by severe headache for more than 72h that did not respond to treatment, with risk of stroke and suicide. Researches on treatment are directed to drugs that stimulate GABA receptors; propofol and isoflurane act on sub-GABAa receptors and theoretically could be interesting. The first has been the subject of research in severe migraine. Opioids are employed in pain, and its use in chronic headache is debatable, but these agents are employed in acute cases. The goal is to present a case of refractory status migrainosus in that we decided to break the pain cycle by general anesthesia. Female patient, aged 50 years, with status migrainosus, in the last five days with visits to the emergency department, medicated parenterally with various agents without result. Without comorbidities, dehydrated, described her pain as well over 10 in Visual Numeric Scale (VNS). After consulting the literature, and given the apparent severity of the condition, we opted for a general anesthesia: induction with fentanyl, propofol, and vecuronium and maintenance with isoflurane and propofol for two hours. Following the treatment, in the postanesthetic recuperation (PAR), the patient related her pain as VNS 3, and was released after five hours with VNS 2. Subsequently, her preventive treatment was resumed. Status migrainosus is a rare disabling complication and anesthetics have been the subject of research in its treatment; the option for general anesthesia with agents that stimulate GABA receptors, propofol and isoflurane, in association with fentanyl, proved effective and should encourage new research.
Subject: Anestesia Geral
Combined Therapy
General Anesthesia
Migraine Disorder
Terapia Combinada
Transtorno De Enxaqueca
Citation: Brazilian Journal Of Anesthesiology (elsevier). v. 65, n. 5, p. 407-410
Rights: fechado
Identifier DOI: 10.1016/j.bjane.2013.09.011
Appears in Collections:Unicamp - Artigos e Outros Documentos

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