Opioid does little to ease pain in aSAH-related headache

Use of opioids results in small reductions in pain among adult patients with an aneurysmal subarachnoid haemorrhage (aSAH)-related headache, and higher doses do not appear to significantly boost its efficacy in relieving pain, according to a study.

This retrospective study included adult aSAH patients (Hunt and Hess grades I‒III) admitted to a neurosciences intensive care unit. The authors used descriptive and inferential statistics to characterize headache treatment strategies and opioid-associated decrease in pain scores.

Nearly all patients (97.6 percent) were prescribed opioids for the management of aSAH-related headache. The median decrease in pain after opioid use was ‒1, and the association between opioid dose and change in pain scores was negligible (r_s=0.01).

In addition, several patients (68.8 percent) were discharged on an opioid analgesic with predictive factors including severe headache (odds ratio [OR], 2.52, 95 percent confidence interval [CI], 1.04‒6.14) and oral morphine milligram equivalents ≥60 mg per day during the hospital stay (OR, 3.02, 95 percent CI, 1.22‒7.47).

“A high percentage of patients remained on opioids throughout hospitalization and were eventually discharged on an opioid,” the authors said.