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Am J Emerg Med. 2016 Nov;34(11):2140-2145. doi: 10.1016/j.ajem.2016.08.002. Epub 2016 Aug 5.

Treatment in carbon monoxide poisoning patients with headache: a prospective, multicenter, double-blind, controlled clinical trial.

Author information

1
Department of Emergency Medicine, Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey. Electronic address: drtarik1977@gmail.com.
2
Department of Emergency, Ataturk University Medical Faculty, Erzurum, Turkey. Electronic address: dret25@gmail.com.
3
Department of Emergency, Bagcilar Research and Teaching Hospital, Istanbul, Turkey. Electronic address: drmustafabasturk@gmail.com.
4
Department of Emergency, Abant Izzet Baysal University Medical Faculty, Bolu, Turkey. Electronic address: drarifduran@gmail.com.
5
Department of Emergency, Faculty of Medicine, Pamukkale University, Denizli, Turkey. Electronic address: aserinken@hotmail.com.
6
Department of Emergency, Ataturk University Medical Faculty, Erzurum, Turkey. Electronic address: mucahitemet@gmail.com.

Abstract

BACKGROUND:

There is a lack of specificity of the analgesic agents used to treat headache and underlying acute carbon monoxide poisoning.

OBJECTIVE:

To compare effectiveness of "oxygen alone" vs "metoclopramide plus oxygen" vs "metamizole plus oxygen" therapy in treating carbon monoxide-induced headache.

DESIGN:

A prospective, multicenter, double-blind, controlled trial.

SETTING:

Three emergency departments in Turkey.

POPULATION:

Adult carbon monoxide poisoning patients with headache.

METHODS:

A total of 117 carbon monoxide-intoxicated patients with headache were randomized into 3 groups and assessed at baseline, 30 minutes, 90 minutes, and 4 hours.

MAIN OUTCOME MEASURE:

The primary outcome was patient-reported improvement rates for headache. Secondary end points included nausea, need for rescue medication during treatment, and reduction in carboxyhemoglobin levels.

RESULTS:

During observation, there was no statistical difference between drug type and visual analog scale score change at 30 minutes, 90 minutes, or 4 hours, for either headache or nausea. No rescue medication was needed during the study period. The reduction in carboxyhemoglobin levels did not differ among the 3 groups.

CONCLUSION:

The use of "oxygen alone" is as efficacious as "oxygen plus metoclopramide" or "oxygen plus metamizole sodium" in the treatment of carbon monoxide-induced headache.

PMID:
27553827
DOI:
10.1016/j.ajem.2016.08.002
[Indexed for MEDLINE]

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