The following is a summary of “High or mid-flow oxygen therapy for primary headache disorders: A randomized controlled study,” published in the June 2023 issue of Emergency Medicine by Kaçer, et al.

Headache is a common reason for emergency department (ED) visits, and high-flow oxygen therapy has emerged as a potentially effective and cost-efficient treatment option. For a study, researchers sought to compare the effectiveness of high-flow and medium-flow oxygen therapies with placebo for managing primary headache disorders in middle-aged patients. A prospective, double-blind, placebo-controlled, crossover-designed, randomized study was conducted at a regional tertiary hospital’s ED. 

Patients treated for primary headache disorder in the ED were evaluated at diagnosis and subsequently included in the study during their next ED visit. Four treatment methods were administered to all patients: high-flow oxygen (15 L/min oxygen), medium-flow oxygen (8 L/min oxygen), high-flow room air as placebo (15 L/min room air), and medium-flow room air as placebo (8 L/min room air). The treating physician recorded data on demographics, medical history, additional complaints, Visual Analogue Scale (VAS) scores, and physical examination findings.

The study included 104 patients with a mean age of 35.14 ± 9.1 years. Patients who received oxygen therapy had significantly lower VAS scores at all time points (15, 30, and 60 minutes) compared to placebo (P < 0.001), with the most significant difference observed at 30 minutes. There was no significant statistical difference between high-flow and mid-flow therapies (P > 0.05). Patients receiving placebo therapy were likelier to revisit the ED (P < 0.05). In contrast, there was no significant difference between high-flow and mid-flow therapy groups in terms of revisits (P > 0.05) and the 30th-minute analgesia requirement (P > 0.05). Patients who received oxygen therapy experienced shorter pain duration (P < 0.05), and those receiving high-flow oxygen therapy spent less time in the ED (P < 0.001).

Oxygen therapy was a beneficial treatment option for middle-aged patients with primary headache disorders. Based on the results, starting treatment with mid-flow oxygen may be more suitable, considering the outcomes obtained from high and mid-flow oxygen therapies.

Source: sciencedirect.com/science/article/abs/pii/S0735675723001511