Table 2.
Author | Drug | Concen-tration | Volume | Condition | RCT | Effect | Nr of patients | Technique | Ref. |
---|---|---|---|---|---|---|---|---|---|
Sluder | Cocaine | 4–70% | A drop | Meckel’s ganglion neuralgia | No | Positive effect in a series of patients | 5 | Applicator, surgery | [7] |
Alcohol | – | A drop | |||||||
formaldehyde | 0,4% | N/S | |||||||
Silver nitrate | 2% | N/S | |||||||
Barre | Cocaine | 5–10% | N/S | CH | No | Positive effect in a series of patients | 11 | Barre’s techniquea | [20] |
Kittrelle | Cocaine | 5% | – | CH (NTG-induced) | No | > 75% reduction in headache intensity within 3 min, in 4 of 5 patients with lidocaine | 5 | Barre’s techniquea | [12] |
lidocaine | 4% | 1 ml | |||||||
Hardebo | Cocaine | 10% | 0,3 ml | CH | No | Lidocaine and cocaine equally effective | 24 | Nasal droper | [27] |
Lidocaine | 4% | 0,5–0,8 ml | |||||||
Robbins | Lidocaine | 4% | 4–6 sprays | CH | No | 54% mild to moderate relief after treatment | 30 | Spray | [26] |
Kudrow | Lidocaine | 4% | 0,4 ml | Migraine | No | Migraine attacks aborted in 12 of 23 patients | 23 | Barre’s techniquea | [38] |
Maizels | Lidocaine | 4% | 0,5 ml | Migraine | Yes | 55% of patients that received lidocaine had at least 50% reduction of headache within 15 min (primary endpoint) | 81 | Barre’s techniquea | [4] |
Maizels | Lidocaine | 4% | 0,5 ml | Migraine | Yes | Randomized trial with open-label follow-up. Controlled trial: 35.8% of patients had headache relieved to mild or none 15 min. After treatment. | 131 | Barre’s techniquea | [5] |
Maizels | Lidocaine | 4% | 0,5 ml | Migraine | No | Prevention of the development of headache following aura. | 1 | Barre’s techniquea | [39] |
Saberski | Lidocaine | 20% | N/S | Postherpetic neuralgia | No | Decrease of the pain (therapy repeated 11 times) | 1 | Applicator dipped in anaesthetic | [40] |
Costa | Lidocaine | 10% | 1 ml | CH (NTG-induced) | Yes | All patients responded to both anaesthetics with complete cessation of induced pain (31.3 ± 13.1 min for cocaine and 37.0 ± 7.8 for lidocaine. For saline, pain severity increased initially and resolved with a latency of 59.3 ± 12.3 min. | 15 | Cotton swab under rhinoscopy | [34] |
Cocaine | 10% | 1 ml | |||||||
Blanda | Lidocaine | 4% | 1 ml | Migraine | Yes | The study was negative for the main outcome measure (decrease of ≥50% of initial pain score or an absolute pain score ≤ 2.5 cm at 5 min. | 49 | Barre | [29] |
Windsor | Lidocaine | 2% | 1–2 ml | Herpes keratitis | No | Relief of pain in one case report | 1 | Applicator developed by the authors | [15] |
Chae | Lidocaine | 2% | N/S | Post-traumatic headache | No | Reduction of VAS scale within 15 min in both patients (from 8/10 to 0/10 in the first and from 10/10 to 2/10 in the second) | 2 | N/S | [41] |
Cohen | Lidocaine | 4% | N/S | Postdural puncture headache | No | Relief of pain in a series of patients | 13 | Applicator saturated | [42] |
Bakbak | Lidocaine | 10% | 2 ml | CH | No | Relieve of pain and autonomic symptoms | 1 | Cotton-tipped applicator | [43] |
Pfaffenrath | Lidocaine | 6% | 0,1 ml | Migraine | Yes | Primary endpoint not met: proportion of pain-free patients two hours after treatment. Improvement of several secondary endpoints. | 140 | Spray | [30] |
Ketorolac | 0,1 ml | ||||||||
Candido | Ropivacaine | 0,5% | 0,5 ml | 1 TN, 1 CM, 1 post-herpetic neuralgia | No | All 3 patients reported pain relief within the first 15 min. Post-treatment. | 3 | Tx360® | [44] |
Dexamethasone | – | – | |||||||
Cady | Bupivacaine | 0,5% | 0,3 ml | Chronic migraine | Yes | Reduction of pain compared to placebo at 15 min, 30 min and 24 h compared to placebo (primary endpoint). Decreased HIT-6 score compared to placebo at 1 and 6 months. | 38 | Tx360® | [30] |
Mohammadkarimi | Lidocaine | 10% | 1 puff | Acute headache | Yes | Significant reduction of mean pain scores at 1 min (primary endpoint). The effect was sustained at 30 min | 90 | Spray | [37] |
Cohen | Lidocaine | 5% | N/S | Postdural puncture headache | No | Relief of pain in a series of patients | 32 | Applicator saturated | [45] |
Cady | Bupivacaine | 0,5% | 0,3 ml | Chronic migraine | Yes | Primary endpoint: statistically significant reduction of NRS scores. A comparison of the number of headache days during the baseline period and 1 month post-treatment was not significant. | 38 | Tx360® | [32] |
Schaffer | Bupivacaine | 0,5% | 0,3 ml | Acute headache | Yes | Primary endpoint (50% reduction in pain at 15 min) negative. | 93 | Tx360® | [31] |
Androlaukis | Bupivacaine | 0,5% | 0,6 ml | Hemicrania continua | No | Reduction in average intensity and frequency of headaches and autonomic symptoms. | 1 | Tx360® | [3] |
Dance | Lidocaine | 4% | N/S | Migraine (pediatric patients age 7–18) | No | Reduction of pain scores (only abstract available). | 85 | Allevio® | [46] |
LA local anesthetic, SPF sphenopalatine foramen, RCT randomized clinical trial, CH cluster headache, N/S not specified, TN trigeminal neuralgia, CM chronic migraine, NTG nitroglycerine
aBarre’s technique: the patient lies supine with extended neck (45 degrees) and head rotated 30 degrees ipsilateral to the pain. After the desired volume of anesthetic is applied, the patient should stay in the described position for 30 s. [3–5, 7, 12, 13, 15, 20, 26, 27, 29–32, 34, 37–46]