{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:24:38Z","timestamp":1792819478129,"version":"4.5.0"},"reference-count":36,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,3,10]],"date-time":"2022-03-10T00:00:00Z","timestamp":1646870400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This review was designated to evaluate the efficacy of parenteral ketorolac in treating acute migraine headache.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched databases Cochrane Central Register of Controlled Trials (CENTRAL), Medline, and Google Scholar up to January 2021 and identified randomized controlled trials comparing ketorolac to any other medications in treating patients presenting with migraine headache.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirteen trials were included in our review, comprising 944 participants. We derived seven comparisons: ketorolac versus phenothiazines, metoclopramide, sumatriptan, dexamethasone, sodium valproate, caffeine, and diclofenac. There were no significant differences in the reduction of pain intensity at 1\u00a0h under the comparisons between ketorolac and phenothiazines (standard mean difference [SMD]\u00a0= 0.09, p\u00a0= 0.74) or metoclopramide (SMD\u00a0= 0.02, p\u00a0= 0.95). We also found no difference in the outcome recurrence of headache (ketorolac vs. phenothiazines (risk ratio [RR]\u00a0=0.98, p\u00a0= 0.97)], ability to return to work or usual activity (ketorolac vs. metoclopramide [RR\u00a0= 0.64, p\u00a0= 0.13]), need for rescue medication (ketorolac vs. phenothiazines [RR\u00a0= 1.72, p\u00a0= 0.27], ketorolac vs. metoclopramide [RR 2.20, p\u00a0= 0.18]), and frequency of adverse effects (ketorolac vs. metoclopramide [RR\u00a0= 1.07, p\u00a0= 0.82]). Limited trials suggested that ketorolac offered better pain relief at 1\u00a0h compared to sumatriptan and dexamethasone; had lesser frequency of adverse effects than phenothiazines; and was superior to sodium valproate in terms of reduction of pain intensity at 1\u00a0h, need for rescue medication, and sustained headache freedom within 24\u00a0h.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ketorolac may have similar efficacy to phenothiazines and metoclopramide in treating acute migraine headache. Ketorolac may also offer better pain control than sumatriptan, dexamethasone, and sodium valproate. However, given the lack of evidence due to inadequate number of trials available, future studies are warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14457","type":"journal-article","created":{"date-parts":[[2022,2,9]],"date-time":"2022-02-09T16:33:11Z","timestamp":1644424391000},"page":"1118-1131","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Efficacy of ketorolac in the treatment of acute migraine attack: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5482-5890","authenticated-orcid":false,"given":"Mohd Noor","family":"Nurathirah","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Universiti Sains Malaysia, School of Medical Sciences  Kubang Kerian Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1177-7264","authenticated-orcid":false,"given":"Mohd Boniami","family":"Yazid","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Universiti Sains Malaysia, School of Medical Sciences  Kubang Kerian Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6372-1476","authenticated-orcid":false,"given":"Mohd Noor","family":"Norhayati","sequence":"additional","affiliation":[{"name":"Department of Family Medicine Universiti Sains Malaysia, School of Medical Sciences  Kubang Kerian Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamarul Aryffin","family":"Baharuddin","sequence":"additional","affiliation":[{"name":"Hospital Universiti Sains Malaysia  Kubang Kerian Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mimi Azliha","family":"Abu Bakar","sequence":"additional","affiliation":[{"name":"Hospital Universiti Sains Malaysia  Kubang Kerian Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,3,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-019-1053-5"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30322-3"},{"issue":"4","key":"e_1_2_7_4_1","first-page":"CD005220","article-title":"Drugs for the acute treatment of migraine in children and adolescents","volume":"4","author":"Richer L","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.12499"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0736-4679(98)00136-X"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-199753010-00012"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/papr.12198"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2012.02097.x"},{"issue":"12","key":"e_1_2_7_10_1","first-page":"921","article-title":"Ketorolac, an injectable nonnarcotic analgesic","volume":"9","author":"Litvak KM","year":"1990","journal-title":"Clin Pharm"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.12009"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0333102419828967"},{"key":"e_1_2_7_13_1","unstructured":"RohatgiA.WebPlotDigitizer software. 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