Hyperbaric
oxygen administration resulted in relief of migraine headache.
Clinical Bottom Line:
1.
Application of hyperbaric oxygen resulted in complete or partial relief
of headache in significantly more patients than a placebo pressure exposure.
Appraised
by: Mike Bennett, Dept. of Diving and
Hyperbaric Medicine, Prince of Wales Hospital
Sydney; Thursday, 26 November,
1998
Clinical
Scenario: A patient with migraine
headache.
Three-part
Question: For patients with acute
migraine headache, does the application of hyperbaric oxygen therapy compared
with standard prescribed therapy, result in any amelioration of the symptoms.
Search
Terms: Hyperbaric oxygenation,
headache/migraine.
The
Study:
Double-blinded concealed
randomised controlled crossover trial without intention-to-treat. Adult patients
with an established diagnosis of migraine for one year and suffering an acute
headache at the time of study. Compliance with prescribed medication, but no
narcotics during the attack under study.
Control group (N = 10; 10
analysed): Prescribed medication (not specified) and sham hyperbaric oxygen
therapy on air at 2ATA for 45 minutes.
Experimental group (N = 9; 9
analysed): As above, but hyperbaric oxygen at 2ATA for 45 minutes.
The
Evidence:
|
Outcome |
Time to
Outcome |
Air group |
HBO group |
Relative
risk reduction |
Absolute
risk reduction |
NNT |
|
Relief of
headache |
45 minutes |
0 |
1.0 |
INF |
1.0 |
1 |
|
95% CI |
|
|
|
|
1.0 to 1.0 |
1 to 1 |
Comments:
1. Small study with a crossover
design, but no return to baseline at crossover.
2. No details of those not
completing the protocol.
3. No details given on the
proportion with complete as compared to partial relief.
Expiry
date: November 2003
References:
1. Hill RK, A blinded, crossover controlled study of the use
of hyperbaric oxygen in the treatment of migraine headache. Undersea Biomedical
Research Supplement 1992; 19:106.
