Comparing the effects of 3 oxygen delivery methods plus intravenous ketorolac on primary headaches: A randomized clinical trial.

Abstract

OBJECTIVE:

To compare three different oxygen therapy methods in primary headaches.

METHODS:

Design: A randomized placebo-controlled clinical trial was conducted between January 2016 and October 2017.

SETTING:

The emergency department of a university-affiliated urban hospital in Tehran, Iran.

PARTICIPANTS:

Adult patients (aged 18 years and above) with moderate and severe primary headaches (VAS score of 4 or more).

INTERVENTIONS:

Participants were allocated to one of four groups. Group A (n = 34) received 30 mg of intravenous ketorolac plus oxygen at 15 l/min (min) through a non-rebreather mask (NRB), group B (n = 34) received 30 mg of intravenous ketorolac plus 7 l/min of oxygen through a 60% venturi mask, group C (n = 34) received 30 mg of intravenous ketorolac plus 4 l/min of oxygen through a nasal cannula and group D (n = 34) received 30 mg of intravenous ketorolac and room air.

MAIN OUTCOMES MEASURED:

Pain was assessed using the visual analog scale (VAS) at 0, 15, 30 and 60 min after admission.

RESULTS:

Altogether, 136 patients were included. The most significant VAS change occurred in the NRB group at 30 min (p-value = 0.001). At this point, pain reduction in the NRB group was clinically higher than for the venturi and nasal cannula groups, but this effect had disappeared at 60 min.

CONCLUSION:

Although the non-rebreather mask was significantly more effective at 30 min, after 60 min, none of the groups met the endpoint criterion of a 1.3-cm difference on the VAS scale.

• Authors: Morteza Saeedi, Seyed Mohammad Shahvaran, Mahtab Ramezani, Hossein Rafiemanesh, Ehsan Karimialavijeh
• Journal: The American journal of emergency medicine (Am J Emerg Med) Vol. 38 Issue 1 Pg. 55-59 (01 2020) ISSN: 1532-8171 [Electronic] United States
• PMID: 31005396 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Copyright © 2019 Elsevier Inc. All rights reserved.

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Ketorolac

Topics

• Administration, Intravenous
• Adult
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Emergency Service, Hospital
• Female
• Headache (drug therapy, therapy)
• Humans
• Iran
• Ketorolac (therapeutic use)
• Male
• Oxygen Inhalation Therapy (methods)
• Pain Measurement
• Single-Blind Method