• Tarik Ocak, Erdal Tekin, Mustafa Basturk, Arif Duran, Mustafa Serinken, and Mucahit Emet.
• Department of Emergency Medicine, Kanuni Sultan Suleyman Education and Research Hospital, Istanbul, Turkey. Electronic address: drtarik1977@gmail.com.
• Am J Emerg Med. 2016 Nov 1; 34 (11): 2140-2145.

BackgroundThere is a lack of specificity of the analgesic agents used to treat headache and underlying acute carbon monoxide poisoning.ObjectiveTo compare effectiveness of "oxygen alone" vs "metoclopramide plus oxygen" vs "metamizole plus oxygen" therapy in treating carbon monoxide-induced headache.DesignA prospective, multicenter, double-blind, controlled trial.SettingThree emergency departments in Turkey.PopulationAdult carbon monoxide poisoning patients with headache.MethodsA 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 MeasureThe 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.ResultsDuring 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.ConclusionThe use of "oxygen alone" is as efficacious as "oxygen plus metoclopramide" or "oxygen plus metamizole sodium" in the treatment of carbon monoxide-induced headache.Copyright © 2016 Elsevier Inc. All rights reserved.

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