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2012-02-17T01:46:31Z

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'''Hyperbaric oxygenation did not improve duration or intensity of headache in patients with established cluster headache. '''
{|
| '''Clinical bottom line:''' 1. No evidence that HBO improves outcome in cluster headache compared to a sham therapy.
|-
|}
'''Citation/s:'''1. AIM. Nilsson Remahl, R. Ansjon, F. Lind, E. Waldenlind. Hyperbaric oxygen treatment of active cluster headache: a double-blind placebo-controlled cross-over study. Cephalalgia 2002; 22:730-739.
'''Lead author's fax:''' +46 8774 48 22
'''Three-part Clinical Question:''' For patients with cluster headache does the application of HBO, compared to a standard treatment with normobaric oxygen during a cluster, result in prevention or shortening of headache clusters?
'''Search Terms:''' cluster headache.
'''The Study:'''Double-blinded randomised cross-over trial with intention-to-treat.
'''The Study Patients:''' Patients with chronic or episodic CH, with at least six headaches during the week prior to enrolment, and an expected remaining CH period of > 4 weeks. Excluded if using prophylactic treatment.
'''Control group''' (N = 12; 12 analysed): Sham treatment using 10% oxygen for 70 minutes at 2.5 ATA for two sessions 24 hours apart. Rescue simple analgesia if required.
'''Experimental group''' (N = 10; 10 analysed): HBO treatment with 100% oxygen as above.
'''The Evidence:'''

{|
| '''Outcome''' || '''Time to Outcome''' || '''Sham rate''' || '''HBO rate''' || '''Relative risk reduction''' || '''Absolute risk reduction''' || '''NNT'''
|-
| '''>50% reduction in HI.''' || 1 week || 0.38 || 0.36 || -5% || -0.02 || 56 
|-
|^ |||||| 95% Confidence Intervals: || -97% to 87% || -0.36 to 0.33 || NNT ''' 3 to INFNNH ''' 3 to INF
|-
|}
'''Comments:'''
1. Small study with low power to detect important differences between groups.
2. Patients were divided into chronic and episodic groups after primary analysis.
3. 2 patients had remission of headaches for >1 year after sham treatment and were therefore not crossed over.
4. 5 patients required mild to moderate attacks during sham treatment, none during HBO.
5. Authors measured a number of serum markers of vasoactivation, but reported no significant differences.
6. Results poorly reported with apparent 'post-hoc' comparisons.

'''Appraised by''': Jetske van Breda and Mike Bennett, Prince of Wales Hospital; Monday, December 15, 2003Email: [[mailto:Jetskevanbreda@hotmail.com | Jetskevanbreda@hotmail.com]]
'''Kill or Update By:''' December 2015

[[File:http://www.hboevidence.com/_themes/copy-of-sumi-painting/sumhorsa.gif|center|external]]

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