March 1, 2018

Background: There are several classes of medications available to treat pediatric migraines and because of this many providers have different combinations that they like to use.  Typically, NSAIDs, anticholinergics, and dopamine antagonists are used with varying degrees of success.  There is little evidence to guide providers if these agents fail in terms of which medications would be helpful for further abortive therapy.  There have been several trials published in the adult population regarding the use of low dose propofol (LDP) for acute migraines.  Propofol is great in the ED setting due to its short acting duration of action, as well as its anti-emetic properties.  Many things done in pediatrics are extrapolated from adult literature, however the authors of this paper wanted to see if LDP was any better than standard therapy (ST) in the treatment of acute pediatric migraines.