title: Efficacy of high-flow oxygen therapy in all types of headache: a prospective, randomized, placebo-controlled trial.
abstract: OBJECTIVE
  We aimed to assess the efficacy of oxygen inhalation therapy in emergency department (ED) patients presenting with all types of headache.
  
  
  METHODS
  We performed a prospective, randomized, double-blinded, placebo-controlled trial of patients presenting to the ED with a chief complaint of headache. The patients were randomized to receive either 100% oxygen via nonrebreather mask at 15 L/min or the placebo treatment of room air via nonrebreather mask for 15 minutes in total. We recorded pain scores at 0, 15, 30, and 60 minutes using the visual analog scale. At 30 minutes, the patients were assessed for the need for analgesic medication. Patient headache type was classified by the treating emergency physician using standardized diagnostic criteria.
  
  
  RESULTS
  A total of 204 patients agreed to participate in the study and were randomized to the oxygen (102 patients) and placebo (102 patients) groups. Patient headache types included tension (47%), migraine (27%), undifferentiated (25%), and cluster (1%). Patients who received oxygen therapy reported significant improvement in visual analog scale scores at all points when compared with placebo: 22 mm vs 11 mm at 15 minutes (P < .001), 29 mm vs 13 mm at 30 minutes (P < .001), and 55 mm vs 45 mm at 60 minutes (P < .001). When questioned at 30 minutes, 72% of patients in the oxygen group and 86% of patients in the placebo group requested analgesic medication (P = .005).
  
  
  CONCLUSIONS
  In addition to its role in the treatment of cluster headache, high-flow oxygen therapy may provide an effective treatment of all types of headaches in the ED setting.
authors.affiliation: Department of Emergency Medicine, Gulhane Military Medical Academy, GATA Acil Tip Anabilim Dalı, Etlik, Ankara 06010, Turkey. drbirsenozkurt@yahoo.com
authors.forename: Birsen
authors.initials: B
authors.lastname: Ozkurt
authors.forename: Orhan
authors.initials: O
authors.lastname: Cinar
authors.forename: Erdem
authors.initials: E
authors.lastname: Cevik
authors.forename: Ayhan Yahya
authors.initials: AY
authors.lastname: Acar
authors.forename: Deniz
authors.initials: D
authors.lastname: Arslan
authors.forename: Emrah Yusuf
authors.initials: EY
authors.lastname: Eyi
authors.forename: Loni
authors.initials: L
authors.lastname: Jay
authors.forename: Levent
authors.initials: L
authors.lastname: Yamanel
authors.forename: Troy
authors.initials: T
authors.lastname: Madsen
mesh_terms: D000328:Adult; D003027:Cluster Headache / Q000628:therapy; D004311:Double-Blind Method; D004636:Emergency Service, Hospital; D006261:Headache / Q000628:therapy*; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000628:therapy; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D010147:Pain Measurement; D018781:Tension-Type Headache / Q000628:therapy