UMEM Educational Pearls

Category: Neurology

Title: IV Fluids for Headache?

Keywords: headache, migraine, intravenous fluids, IVF (PubMed Search)

Posted: 3/8/2017 by WanTsu Wendy Chang, MD
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IV Fluids for Headache?
  • Headache is the 4th most common ED visit in the US.
  • Clinical experience suggests that IV fluids (IVF) are commonly used as adjunctive treatment for headaches, however, the efficacy is unknown.
  • A retrospective study using the National Hospital Ambulatory Medical Care Survey (NHAMCS) found that ED length of stay was significantly greater in patients who received IVF than in those who did not (202 min vs. 131 min, p<0.001) even after adjusting for initial pain score, sex, age, and mode of arrival. 
  • A post-hoc analysis of data collected from 4 ED-based migraine trials found that IVF was not associated with improvement of pain score or sustained headache freedom.
  • There is no current evidence to suggest a direct analgesic effect of IVF in the treatment of headaches.



  • Jones CW, et al. Epidemiology of intravenous fluid use for headache treatment: Findings from the National Hospital Ambulatory Medical Care Survey. Am J Emerg Med. 2017. [Epub ahead of print]
  • Balbin JEB, et al. Intravenous fluids for migraine: a post hoc analysis of clinical trial data. Am J Emerg Med. 2016;34:713-6.

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