Hyperbaric
oxygen did not terminate migraine headache.
Clinical Bottom Line:
1.
There was no statistically significant increase in the number of patients with
headache resolution when given hyperbaric oxygen.
Appraised
by: Mike Bennett, Dept. of Diving and
Hyperbaric Medicine, Prince of Wales Hospital
Sydney; Thursday, 26 November,
1998
Clinical
Scenario: A patient suffering a
migranous headache.
Three-part
Question: In patients experiencing
migraine headache, does the application of hyperbaric oxygen compared to a
normoxic exposure to pressure, result in any earlier termination, or
amelioration, of the headache symptoms?
Search
Terms: Hyperbaric oxygenation,
headache.
The
Study:
Double-blinded concealed
randomised controlled trial with intention-to-treat.
Adult, non-pregnant patients
with established diagnosis of migraine less frequent than daily headache.
Control group (N = 4; 4 analysed):
Patients were compressed to 2ATA for 45 minutes and give 10% nitrox to maintain
normoxia during the sham hyperbaric exposure.
Experimental group (N = 10; 10
analysed): 100% oxygen at 2.0ATA for 45 minutes.
The
Evidence:
|
Outcome |
Time to
Outcome |
Control |
HBO |
Relative
risk reduction |
Absolute
risk reduction |
Number
needed to treat |
|
Persisting
headache |
45 minutes |
0.50 |
0.30 |
40% |
0.20 |
5 |
|
95% CI |
|
|
|
-73% to 100% |
-0.37 to 0.77 |
NNT= 3 to INF
NNH= 1 to INF |
Comments:
1. Very small study where the
power is low to detect even a highly significant clinical improvement.
2. The trend to improvement in
the hyperbaric group may be confirmed in a more powerful study.
3. Little detail on how the
outcomes were measured.
4. Described as preliminary, but
no further results located.
5. No explanation for large
difference in the recruitment between the arms.
Expiry
date: November 2003
References:
1. Fife CE, Meyer JS, Berry JM, Sutton TE. Hyperbaric oxygen and acute migraine pain: preliminary results of a randomised blinded trial. Undersea Biomedical research 1992; 19:106-107.
