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Topical Intranasal Anesthetic Block for Reducing the Pain of Botulinum Toxin Injections for Chronic Migraine

Topical Intranasal Anesthetic Block for Reducing the Pain of Botulinum Toxin Injections for Chronic Migraine: A Randomized, Double-Blind, Placebo-Controlled Crossover Pilot Study

Who can join

Ages 18 and older · All sexes

Inclusion Criteria:

* Aged ≥18 years
* Any gender
* Able to provide informed consent
* Meets clinical criteria for onabotulinumtoxinA for chronic migraine (minimum of 2 days of disability per month due to facial or headache pain, or 8 headache days per month, or more than 15 headaches per month)
* Scheduled for modified PREEMPT injections at the clinical site

Exclusion Criteria:

* Aged \< 18 years
* Trigeminal neuralgia, cluster headache, or other primary headache disorders as dominant diagnosis
* Not able to provide informed consent
* Known allergy/hypersensitivity to lidocaine or amide anesthetics
* Pregnancy/lactation
* Inability to tolerate intranasal nasal cotton pledgets
* Significant nasal pathology at placement site

About the study

People find the injections used in onabotulinumtoxinA (Botox®) uncomfortable. This study will test whether putting a small piece of cotton soaked with 4% lidocaine (a numbing medicine) inside the front of each nostril for 5 minutes before the injections reduces injection pain compared with cotton soaked in saline (salt water).

What is being tested

• onabotulinumtoxinA prophylaxis with Lidocaine (procedure)
• OnabotulinumtoxinA prophylaxis with Saline (procedure)

Sponsor: Association of Migraine Disorders · Participants: 18 · Started: Mar 3, 2026

Contact the study team

• Frederick A Godley, MD · Phone: 401-274-2300

Official record on ClinicalTrials.gov — NCT07571889

Locations in the U.S.

From ClinicalTrials.gov, data retrieved Oct 2, 2026. Each study sets its own eligibility; the study team decides who can join.