{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T18:52:11Z","timestamp":1791399131014,"version":"4.3.3"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,6,7]],"date-time":"2022-06-07T00:00:00Z","timestamp":1654560000000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001804","name":"Canada Research Chairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001804","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000145","name":"Alberta Innovates - Health Solutions","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000145","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this study was to assess the efficacy and safety of a common monotherapy (intravenous [iv] metoclopramide) compared to a combination strategy (adding iv ketorolac to metoclopramide) in children presenting for acute treatment of migraine headache in the emergency department (ED).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Children aged 5\u201317\u00a0years presenting for acute treatment of migraine headache at two pediatric EDs were enrolled in a double\u2010blind randomized controlled trial. Children were randomly assigned to receive iv metoclopramide 0.2\u00a0mg\/kg) and placebo or iv metoclopramide (0.2\u00a0mg\/kg) and ketorolac (0.5\u00a0mg\/kg). The primary outcome was a mean change in pain from baseline to 120\u00a0min via a 100\u00a0mm Visual Analog Scale (VAS). Follow\u2010up was conducted 24\u2010h after discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty\u2010three children were randomized and included in the analysis (monotherapy group [metoclopramide + placebo],\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a027; and ketorolac group [metoclopramide + ketorolac],\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a026); mean age was 12.9\u00a0\u00b1\u00a02.7\u00a0years and baseline pain severity on VAS was 67.3\u00a0\u00b1\u00a02.7\u00a0mm. The mean change in pain intensity at 120\u00a0min was \u221244\u00a0mm (SD: 24; 95% confidence interval [CI]: 32\u201357) for the monotherapy group and \u221236\u00a0mm (SD: 24; 95% CI: 23\u201349) for the ketorolac group, with a mean difference between groups of 8\u00a0mm (95% CI: \u22129\u201325;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.360). Seventeen percent of the children (9\/53; 95% CI: 7\u201327%) were pain\u2010free at discharge. There was no difference in headache recurrence or adverse events between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The approach of combining iv metoclopramide with ketorolac failed to improve pain scores in children presenting for acute treatment of migraine headache in the ED compared to metoclopramide monotherapy. Most patients were discharged with residual pain. Further comparative studies are needed to test alternative ED treatments for migraine in children or adolescents.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.14307","type":"journal-article","created":{"date-parts":[[2022,6,7]],"date-time":"2022-06-07T03:55:13Z","timestamp":1654574113000},"page":"681-689","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["A randomized trial of ketorolac and metoclopramide for migraine in the emergency department"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6897-8668","authenticated-orcid":false,"given":"Lawrence P.","family":"Richer","sequence":"first","affiliation":[{"name":"Department of Pediatrics Faculty of Medicine &amp; Dentistry University of Alberta  Edmonton Alberta Canada"},{"name":"Women and Children\u2019s Health Research Institute, Faculty of Medicine &amp; Dentistry University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samina","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Faculty of Medicine &amp; Dentistry University of Alberta  Edmonton Alberta Canada"},{"name":"Women and Children\u2019s Health Research Institute, Faculty of Medicine &amp; Dentistry University of Alberta  Edmonton Alberta Canada"},{"name":"Department of Emergency Medicine Faculty of Medicine &amp; Dentistry University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Emergency Medicine, and Physiology and Pharmacology University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhonda\u00a0J.","family":"Rosychuk","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Faculty of Medicine &amp; Dentistry University of Alberta  Edmonton Alberta Canada"},{"name":"Women and Children\u2019s Health Research Institute, Faculty of Medicine &amp; Dentistry University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda S.","family":"Newton","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Faculty of Medicine &amp; Dentistry University of Alberta  Edmonton Alberta Canada"},{"name":"Women and Children\u2019s Health Research Institute, Faculty of Medicine &amp; Dentistry University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian H.","family":"Rowe","sequence":"additional","affiliation":[{"name":"Women and Children\u2019s Health Research Institute, Faculty of Medicine &amp; Dentistry University of Alberta  Edmonton Alberta Canada"},{"name":"Department of Emergency Medicine Faculty of Medicine &amp; Dentistry University of Alberta  Edmonton Alberta Canada"},{"name":"School of Public Health University of Alberta  Edmonton Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,7]]},"reference":[{"issue":"6","key":"e_1_2_11_2_1","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_11_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-2337"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-2432"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2018.08.051"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9568.2008.06068.x"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroscience.2007.04.064"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0035-3787(05)85119-7"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(03)00716-9"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2006.05.006"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-1509"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2009.00587.x"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2001.111517"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2006.05.006"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1197\/S1069-6563(03)00372-5"},{"key":"e_1_2_11_16_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2021"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2010.12.020"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000000718"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2020.01.013"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2008.01.334"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/head.12443"}],"container-title":["Headache: The Journal of Head and Face Pain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/head.14307","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/head.14307","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/headachejournal.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/head.14307","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T10:28:41Z","timestamp":1767608921000},"score":1,"resource":{"primary":{"URL":"https:\/\/headachejournal.onlinelibrary.wiley.com\/doi\/10.1111\/head.14307"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6]]},"references-count":20,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,6]]}},"alternative-id":["10.1111\/head.14307"],"URL":"https:\/\/doi.org\/10.1111\/head.14307","archive":["Portico"],"relation":{},"ISSN":["0017-8748","1526-4610"],"issn-type":[{"value":"0017-8748","type":"print"},{"value":"1526-4610","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6]]},"assertion":[{"value":"2021-08-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}