Adjunctive treatment of decompression illness with a non-steroidal anti-inflammatory drug (tenoxicam) reduces compression requirement

Undersea Hyperb Med. Fall 2003;30(3):195-205.

Abstract

We report a randomized trial examining adjunctive administration of the NSAID, tenoxicam, to divers suffering with DCI. 180 subjects were graded for severity on admission and randomized according to a stratified random number schedule. Subjects were recompressed and treatment continued daily until symptom stabilization or complete resolution. Tenoxicam 20 mg or a placebo preparation was administered at the first air break during the initial recompression and continued daily for seven days. The subjects were assessed using a recovery status score at the completion of treatment and at 4-6 weeks. The proportion of patients with mild residual symptoms at discharge and final follow-up was not significantly different (discharge placebo 30% versus tenoxicam 37%, P=0.41; six weeks placebo 20% versus tenoxicam 17%, P=0.58). There was a significant reduction in the number of treatments required to achieve discharge (median treatments placebo 3, tenoxicam 2, P=0.01). 61% of patients in the tenoxicam group required less than 3 compressions, versus 40% in the placebo group (P=0.01, RRR 33 % [95%CI 9%-56%], NNT=5 [95%CI 3-18]). There was no evidence of increased complications of treatment in the tenoxicam group. When given this NSAID, patients with DCI require fewer hyperbaric oxygen (HBO2) sessions to achieve a standard clinical end-point and there is likely to be an associated cost saving.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Algorithms
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Barotrauma / etiology
  • Chemotherapy, Adjuvant
  • Decompression Sickness / drug therapy*
  • Decompression Sickness / therapy
  • Double-Blind Method
  • Ear Diseases / etiology
  • Female
  • Humans
  • Hyperbaric Oxygenation / methods*
  • Male
  • Piroxicam / analogs & derivatives*
  • Piroxicam / therapeutic use*
  • Statistics as Topic
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Piroxicam
  • tenoxicam