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Evidence summaries

Recompression and Adjunctive Therapy for Decompression Illness (Dci)

Addition of tenoxicam (an NSAID) to recompression therapy for decompression illness appears to reduce the number of recompression sessions required, but there is no evidence for an improvement in the rate of complete recovery. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 2 studies with a total of 268 subjects. Pooling of data was not possible. In one study there was no evidence of improved effectiveness with the addition of a non-steroidal anti-inflammatory drug (tenoxicam) to routine recompression therapy (at 6 weeks RR for recovery with tenoxicam 1.04, 95% CI 0.90 to 1.20) but there was a reduction in the number of compressions required when tenoxicam was added from 3 to 2 (P = 0.01, 95% CI 0 to 1). The RR for requiring more than two treatments with tenoxicam was 0.64 (95% CI 0.46 to 0.86; 1 study, n = 180). In the other study, the odds of multiple recompressions was lower with a helium and oxygen (heliox) table compared to an oxygen treatment table (RR 0.56, 95% CI 0.31 to 1.00, P = 0.05).

Comment: The quality of evidence is downgraded by imprecise results (few patients).

    References

    • Bennett MH, Lehm JP, Mitchell SJ et al. Recompression and adjunctive therapy for decompression illness. Cochrane Database Syst Rev 2012;(5):CD005277. [PubMed].

Primary/Secondary Keywords