Myers
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 2015 References: 1. Myers DE, Myers RA. A preliminary report on hyperbaric oxygen in the relief of migraine headache. Headache 1995;35:197-199.
