title: The effect of prophylactic topical steroid cream on the incidence and severity of cutaneous burns following external DC cardioversion.
abstract: BACKGROUND
  Cutaneous burns are a common cause of morbidity following direct current (DC) cardioversion. We designed a prospective double-blinded controlled study to determine whether the application of steroid cream prior to cardioversion reduces their incidence and severity.
  
  
  METHODS
  Two hours before elective DC cardioversion, we applied betamethasone 0.1% cream or placebo cream over sternal and apical pad sites in 56 patients, with patients acting as their own controls. Two hours after cardioversion, a separate blinded observer measured the visual analogue pain score (VAS), sensory and pain detection thresholds, skin temperature and erythema index at sternal and apical pad sites.
  
  
  RESULTS
  The study had an 80% power to detect a 50% difference in VAS at 2 h, accepting an alpha error of 0.05. There was no difference between pain at 2 or 24 h, skin temperature, erythema index, sensory and pain detection thresholds at pad sites treated with steroid cream or control.
  
  
  CONCLUSIONS
  Topical betamethasone 0.1% cream applied 2 h before elective DC cardioversion is no more effective than placebo at reducing the pain and inflammation from cardioversion burns.
authors.affiliation: Shackleton Department of Anaesthetics, Southampton University Hospitals NHS Trust, Tremona Road, Southampton SO16 6YD, UK. jjsa@amblers.org
authors.forename: Jonathan J S
authors.initials: JJ
authors.lastname: Ambler
authors.forename: David A
authors.initials: DA
authors.lastname: Zideman
authors.forename: Charles D
authors.initials: CD
authors.lastname: Deakin
mesh_terms: D000287:Administration, Topical; D000328:Adult; D001623:Betamethasone / Q000008:administration & dosage*; D002058:Burns, Electric / Q000209:etiology* / Q000517:prevention & control*; D004311:Double-Blind Method; D004554:Electric Countershock / Q000009:adverse effects*; D004890:Erythema / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D017288:Pain Threshold / Q000187:drug effects; D011446:Prospective Studies; D012881:Skin Temperature / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D001623:Betamethasone