ANA: CO2 Nasal Spray Relieves Migraine Pain - CME Teaching Brief - MedPage Today

ANA: CO2 Nasal Spray Relieves Migraine Pain
A device that sends pressurized carbon dioxide up one nostril and out the other — without being inhaled — appears to rapidly abort migraine pain, researchers reported.

A patient experiencing a migraine attack would place the device into one nostril and initiate a flow of carbon dioxide for as long as a minute, Dr. Spierings explained. The gas would actually flow up one nostril and effectively exit the other nostril while patients either hold their breath or keep their mouth closed for about 60 seconds.

While the gas is flowing, carbon dioxide readily permeates the nasal mucous membranes creating carbonic acid and decreasing the pH of the nociceptive nerve fibers, Dr. Spierings said. The acidosis created is potent enough to prevent stimulation of neurons and activation of the pain cascade. A bystander effect that follows prevents activation throughout the trigeminal nerve system.