Hyperbaric
oxygenation terminated migraine headache in the majority of patients.
Clinical Bottom Line:
1.
Application of HBO was associated with termination of headache in the majority
of patients.
2.
Only the immediate effect of the application of HBO has been evaluated.
Appraised
by: Mike Bennett, Dept of Diving and
Hyperbaric Medicine, Prince of Wales Hospital
Sydney; Friday, 13 November,
1998
Clinical
Scenario: an adult with recurrent
migranous headaches.
Three-part
Question: In a patient suffering a
migranous headache, does the administration of 100% oxygen at 2ATA as compared
to 1ATA, result any improvement in symptoms?
Search
Terms: Hyperbaric oxygenation,
migraine.
The
Study:
Single-blinded randomised
controlled trial with intention-to-treat.
Adult patients with an existing
history of migraine headache and suffering a typical attack.
Control group (N = 10; 10
analysed): 100% oxygen at 1ATA via facemask for 40 minutes while seated in the
hyperbaric chamber.
Experimental group (N = 10; 10
analysed): 100% oxygen at 2ATA via a hood for 40 minutes.
The
Evidence:
|
Outcome |
Time
to Outcome |
1
ATA |
2
ATA |
Relative
Risk Reduction |
Absolute
Risk Reduction |
Number
needed to treat |
|
Total
or near total pain relief |
40
mins |
0.1 |
0.9 |
800% |
0.8 |
1 |
|
95%
CI |
|
|
|
100%
to 537% |
1.06
to 0.54 |
1
to 2 |
Comments:
1. Small, pilot study.
2. No attempt to measure any
longer-term effects.
3. Practicality of reaching
treatment may be a problem.
4. Although patients were
described as blind to the treatment group, there were considerable differences
in the experimental procedure in the two arms.
5. The outcomes were not
measured by blinded observers.
Expiry date: November 2003
References:
1. Myers DE, Myers RA. A
preliminary report on hyperbaric oxygen in the relief of migraine headache.
Headache 1995;35:197-199.
