The effectiveness of supplemental oxygen therapy in patients receiving acute migraine treatment in the emergency department: A randomized clinical trial

Abstract

Background & Objective: Migraine headaches are a frequent reason for emergency department (ED) visits. While oxygen therapy has demonstrated effectiveness for cluster headaches, its role in other primary headaches remains a topic of research. This study aimed to investigate the effectiveness of supplemental oxygen therapy, when added to standard treatments, for pain management in patients presenting to the ED with acute migraine without aura.

Methods: This study was a randomized, controlled trial. Patients were randomized using the ‘Random Allocation’ program and divided into two groups. All patients presenting to the ED with migraine without aura received 50 mg dexketoprofen + 10 mg metoclopramide HCl in 100 mL normal saline intravenously as standard treatment. The study group also received humidified oxygen at 10 L/min via a simple face mask for 60 minutes. Data collected included patients’ demographic information, pain characteristics, comorbid diseases, medications used, presence of aura, visual analog scale (VAS) scores at 0, 15, 30, and 60 minutes post-treatment, and the need for rescue treatment.

Results: A total of 160 participants were included: 79 in the oxygen group and 81 in the non-oxygen group. No significant differences were found in demographic data or baseline VAS scores between the groups. VAS scores at 15, 30, and 60 minutes did not show a significant difference between the two groups (p > 0.05 for each measurement using either per-protocol [PP] or intention-to-treat [ITT] analysis). One patient in the oxygen group and two patients in the non-oxygen group required rescue treatment, but this difference was not statistically significant (p = 0.57).

Conclusion: This study suggests that supplemental oxygen therapy does not augment the effectiveness of conventional migraine treatment. Current evidence is insufficient to support the routine use of oxygen in emergency departments for the management of migraine headaches.