Hamid Reza KHALKHALI, Aynaz BAGHERZADI, Roghiyeh EMANI, Haleh GHAVAMI, Marziyeh EBRAHIMI

Kalp hastalarında ısı ve soğuk terapinin nitrogliserine bağlı migren tip baş ağrısı şiddeti üzerine etkilerinin karşılaştırılması: Randomize kontrollü bir çalışma

Amaç: Bu çalışmanın amacı kardiyak hastalarda ısı ve soğuk terapi uygulamasının nitrogliserine bağlı migren tipi baş ağrısı şiddeti üzerine etkilerini karşılaştırmaktı. Gereç ve Yöntem: Bu randomize kontrollü çalışma, ön test ve son test olarak üç grup tasarımında (ısı veya soğuk terapi ve kontrol grubu) toplam 75 kardiyak hasta üzerinde gerçekleştirilmiştir. Müdahale grubundaki hastalar 25 dakika boyunca, iki kez (1 saatlik aralıklarla) ısı veya soğuk terapi aldı, kontrol grubundaki hastalar herhangi bir terapi almadı. Baş ağrısı şiddeti, ağrı için sayısal derecelendirme ölçeği ile, üç çalışma grubunda 3 kez (çalışmadan hemen önce, ilk terapinin uygulanmasının sonunda ve ikinci terapinin uygulanmasının sonunda) ölçülmüştür. Bulgular: Çalışmadan hemen önce üç grup arasında ortalama ağrı skalası skoru (p=0,781) için bazal fark yoktu; ancak ısı ve soğuk terapi uygulandıktan sonra üç grup arasındaki fark istatistiksel olarak anlamlı idi (p=0,000). Sonuç: Bu çalışma, ısı ve soğuk terapi uygulanmasının kardiyak hastalarda nitrata bağlı migren tipi baş ağrısının şiddetini azaltabildiğini göstermiştir. Hastaların yaklaşık %10’unun dayanılmaz baş ağrısından dolayı nitrat tedavilerine tahammül edemediği gerçeği göz önüne alarak, nitrata bağlı migren tipi baş ağrısı olan hastalarda ısı veya soğuk terapi uygulaması, hastanın tedaviye uyumunu artırmak için önerilmektedir.

Comparing the effect of heat and cold therapy on the intensity of nitrate-induced migraine type headache in cardiac inpatients: A randomized controlled trial

Objectives: This study aimed to compare the effect of heat and cold therapy on the intensity of nitroglycerine-induced migrainetype headache in cardiac inpatients.Methods: This randomized controlled trial was conducted on a total of 75 cardiac inpatients in three groups design (heat orcold therapy and control group) as pre-test and post-test. Patients in the intervention group received heat or cold therapy for25 min, 2 times (at 1 h interval), patients in the control group did not receive any heat or cold therapy. Headache intensity wasmeasured by the numeric rating scale for pain, in three groups of study for 3 times (just before the study, at the end of applyingthe first therapy, and at the end of applying the second therapy).Results: No baseline diﬀerences existed among the three groups for the mean pain scale score (p=0.781) just before the study;but the diﬀerence between three groups after applying heat and cold therapy was statistically significant (p=0.000).Conclusion: This study demonstrated that applying heat and cold therapy may reduce the intensity of nitrate-induced migrainetype headache in cardiac inpatients. Considering this fact that approximately 10% of patients cannot tolerate nitratetherapies due to unbearable headache, applying heat or cold therapy in patients with nitrate-induced migraine type headacheis recommended to improve patient’s adherence to treatment.

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1. Soman B, Vijayaraghavan G. The role of organic nitrates in the optimal medical management of angina. E J Cardiol Pract 2017;15(2): 26 Apr 2017. [Epub ahead of print].
2. Juhász G, Zsombók T, Gonda X, Bagdy G. Nitroglycerininduced headaches. Orv Hetil 2004;145(46):2323–8.
3. Cho SH, Jeong MH, Sim DS, Hong YJ, Park HW, Kim JH, et al. Diagnostic value of nitroglycerin-induced headache as a negative predictor of coronary atherosclerosis. Chonnam Med J 2011;47(1):14–9. [CrossRef ]
4. Imani N, Shams SA, Radfar M, Ghavami H, Khalkhali HR. Effect of applying reflexology massage on nitroglycerininduced migraine-type headache: A placebo-controlled clinical trial. Agri 2018;30(3):116–22. [CrossRef ]
5. Gonzalez A, Hyde E, Sangwan N, Gilbert JA, Viirre E, Knight R. Migraines are correlated with higher levels of nitrate-, nitrite-, and nitric oxide-reducing oral microbes in the American gut project cohort. mSystems 2016;1(5):e00105–16.
6. Selekler HM, Komsuoglu S. Unconventional treatment methods in Turkish migraine sufferers. J Headache Pain 2004;5:197–200. [CrossRef ]
7. Ucler S, Coskun O, Inan LE, Kanatli Y. Cold therapy in migraine patients: Open-label, non-controlled, pilot study. Evid Based Complement Alternat Med 2006;3(4)489–93.
8. Emani R, Ghavami H, Radfar M, Khalkhali HR. Impact of chromotherapy on professional quality of life in intensive care unit nurses: A randomized controlled trial. Fatigue Biomed Health Behav 2020;8(4):1–9. [CrossRef ]
9. Vijayan N. Head band for migraine headache relief. Headache 1993;33(1):40–2. [CrossRef ]
10. Edmeads J. Non-pharmacological treatments for headaches. In: Olesen J, Tfelt-Hansen P, Welch KM, editors. The Headaches. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2000. p. 543–4.
11. Bronfort G, Nilsson N, Haas M, Evans R, Goldsmith CH, Assendelf WJ, et al. Non-invasive physical treatments for chronic/recurrent headache. Cochrane Database Syst Rev 2004;3:CD001878. [CrossRef ]
12. VanderpoL J, Bishop B, Matharu M, Glencorse M. Therapeutic effect of intranasal evaporative cooling in patients with migraine: A pilot study. J Headache Pain 2015;16:5. [CrossRef ]
13. Mohamed HG, Mohamed MA. Effect of local heat application on complaints of patients with moderate knee osteoarthritis. Am J Nurs Res 2019;7(2):148–59.
14. Robbins LD. Cryotherapy for headache. Headache 1989;29(9):598–600. [CrossRef ]
15. Erkan H, Kırış G, Korkmaz L, Ağaç MT, Çavuşoğlu İG, Dursun İ, et al. Relationship between nitrate-induced headache and coronary artery lesion complexity. Med Princ Pract 2015;24(6):560–4. [CrossRef ]
16. Dehghan M, Farahbod F. The efficacy of thermotherapy and cryotherapy on pain relief in patients with acute low back pain, a clinical trial study. J Clin Diagn Res 2014;8(9):LC01– 4. [CrossRef ]
17. Garra G, Singer AJ, Leno R, Taira BR, Gupta N, Mathaikutty B, et al. Heat or cold packs for neck and back strain: A randomized controlled trial of efficacy. Acad Emerg Med 2010;17(5):484–9. [CrossRef ]
18. Foralosso HC, Lira J, Ramos J, Neves M, Portolez JL, Bertolini GR. Cryotherapy in tension headache: Analysis of the frequency of symptoms. Neurol Neurosci Rep 2019;2(1):1– 4. [CrossRef ]
19. Sprouse-Blum AS, Gabriel AK, Brown JP, Yee MH. Randomized controlled trial: Targeted neck cooling in the treatment of the migraine patient. Hawaii J Med Public Health 2013;72(7):237–41.