|
1. HBOT did not significantly decrease hours of
migraine headache in the 8 weeks following treatment. |
Citation/s:
1. Eftedal OS, Lydersen S, Helde G, White L, Brubakk AO, Stovner LJ. A
randomised, double-blind study of the prophylactic effect of hyperbaric oxygen
therapy on migraine. Cephalalgia 2004; 24:639-644
Lead author's name and fax: Lars Stovner: lars.stovner@medisin.ntnu.no
Three-part Clinical Question: In migraneurs, does the addition of
prophylactic hyperbaric oxygenation to usual therapy reduce time spent with
headache?
Search Terms: migraine, endothelin
The Study:
Double-blinded concealed randomised controlled trial without intention-to-treat.
The Study Patients: Migraneurs with 2 to 8 attacks each month for three
months prior to enrolment.
Control group (N = 20; 15 analysed): Air breathing at 2 ATA for 30
minutes daily for 3 days.
Experimental group (N = 20; 19 analysed): As above but 100% oxygen
breathing
The Evidence:
|
Measure |
Control
Group |
HBOT
Group |
Difference |
95% CI |
||
|
Mean |
SD |
Mean |
SD |
|||
|
Change in
headache, before versus after therapy (week one, hrs) |
-0.6 |
|
-4.0 |
|
3.4 |
|
|
Change in
headache before versus 8 weeks after therapy (hrs) |
-5.0 |
|
+4.4 |
|
-9.4 |
|
|
Endothelin-1
plasma levels after 3 treatments (pg/ml) |
0.81 |
0.27 |
0.75 |
0.13 |
0.06 |
-0.08 to 0.20 |
|
Outcome |
Time
to Outcome |
Control
Rate |
HBOT
rate |
Relative
risk reduction |
Absolute
risk reduction |
Number
needed to treat |
|
Acute
headache resolution during therapy |
During
therapy |
0.36 |
0.42 |
9% |
0.06 |
17 |
|
95% Confidence
Intervals: |
-49% to 68% |
-0.32 to
0.44 |
NNT = 2 to
INF; NNH = 3 to INF |
|||
Comments:
1. Small study, no power or sample size calculation.
2. Unusual hyperbaric regimen and above normal inspired oxygen tension in
control group.
3. Results given do not allow full evaluation and some values are read from a
graph
4. An analysis investigating the duration of any possible treatment effect for
HBOT did not suggest any significant benefits. Validity unknown.
5. No treatment sparing effect noted (no results given).
Appraised by: Sean Hopson and Mike Bennett, Prince of Wales Hospital, Sydney
; Friday, 8 September 2006
Email: sean@thegasman.org
Kill or Update By: September 2007