Comparing the effect of intranasal lidocaine 4% with peppermint essential oil drop 1.5% on migraine attacks: A double-blind clinical trial

Abstract

Background: Prevalence of migraine, as a chronic neurovascular disorder, was approximately 10.3 and 23.1% among men and women, respectively, mostly in people younger than 40 years old. Migraine is prevalent in different geographic areas worldwide. The present study was designed to compare the impact of intranasal lidocaine 4% and peppermint essential oil drop 1.5% on migraine attacks. Methods: In this double-blind, parallel, randomized controlled trial, 120 adult patients with a diagnosis of migraine based on the International Headache Society criteria were treated with intranasal lidocaine drop 4% or peppermint essential oil drop 1.5% or placebo. Patients expressed their symptoms 5 and 15 min after dripping, and if they still had a headache after 15 min, they were given the second dose. Patients with a second dose of medication, 15 min later recorded their headache rate. All patients recorded their symptoms after 30 min. Symptoms of the patients were followed by a researcher through the phone and in-person after 2 months. Then, the questionnaires were filled. Results: In the present study, there was a significant difference among groups in headache intensity after treatment ( P < 0.001). In 40% of the patients in the peppermint oil and lidocaine groups, the intensity of headache decreased. In the placebo group, fewer patients responded highly to the treatment, whereas 41.5% of patients in the lidocaine group and 42.1% of patients in the peppermint oil group responded to the treatment considerably. Conclusions: Concerning the findings of the present study, nasal application of peppermint oil caused considerable reduction in the intensity and frequency of headache and relieved majority of patients' pain similar to lidocaine. On the basis of findings of this study, it can be concluded that nasal menthol, such as lidocaine, can be used to relieve migraine headaches.

Nonpharmacologic approaches to pain management

“…A 2019 double-blind, randomized controlled trial tested the impact of nasal peppermint oil compared with lidocaine and a placebo in a group of 120 migraine patients. Both peppermint oil and lidocaine successfully decreased pain related to migraine headaches compared with the placebo 12…”

“…Both peppermint oil and lidocaine successfully decreased pain related to migraine headaches compared with the placebo. 12 In another randomized controlled trial designed to determine the effect of inhaled frankincense on labor pain, 126 nulliparous pregnant women were randomly allocated to either an aromatherapy (n = 63) or a placebo (n = 63) group. Statistical analyses using descriptive and inferential statistics demonstrated that labor pain intensity in the aromatherapy group was significantly lower than in the control group at 3 to 4 cm, 5 to 7 cm, and 8 to 10 cm cervical dilation.…”

“…19 In a review of studies on therapeutic touch applied to cancer care, therapeutic touch was found to have a demonstrated positive effect. 20 More research is needed on this modality as there are few methodologically sound studies on therapeu-Using essential oils [10][11][12][13][14][15] Below is a list of various essential oils that may be used as part of a nonpharmacologic approach to pain management. Eucalyptus: can help open air passages and promote ease of breathing, and it is used to treat colds, congestion, and coughs due to its potential antiviral and antibacterial properties, especially in the winter months; it is also being studied for efficacy in pain management.…”

Herbal treatments for migraine: A systematic review of randomised‐controlled studies

“…The efficacy of blinding also posed a potential problem in studies comprising the application of topical preparations (Borhani Haghighi et al, 2010;Niazi et al, 2017;Rafieian-Kopaei et al, 2019;Zargaran et al, 2018), and variability in treatments offered including variances in the number of tablets ingested by groups (Abdolahi et al, 2017;Parohan et al, 2019), differences in treatment administrations (i.e., syrups versus tablets) (Jafarpour et al, 2016), and variability in the intensity of the intervention offered (Ferro et al, 2012;Oelkers-Ax et al, 2008).…”

“…Rafieian-Kopaei et al, 2019). At the onset of the migraine, participants applied two drops intranasally.…”