title: Betamethasone in hernia surgery: a randomized controlled trial.
abstract: BACKGROUND
  Post-operative pain and nausea may be a problem in day-case surgery. This study aims to investigate the effect of betamethasone on pain and nausea in inguinal hernia surgery.
  
  
  METHODS
  Patients aged 18-70 years scheduled for open inguinal hernia surgery at two Swedish hospitals, March 2005-December 2009, were eligible for inclusion. Patients were randomized, to either treatment with 12 mg betamethasone intravenously or placebo. Post-operative pain was assessed using a visual analogue scale on the recovery ward, each day the first post-operative week and at 1 month after surgery. One year after surgery, residual pain was estimated by the Inguinal Pain Questionnaire.
  
  
  RESULTS
  A total of 398 patients were included (21 women, 377 men). Pain at rest on the day of surgery was significantly lower in the treatment group (p = 0.012). The pain was also significantly lower in the treatment group the day after surgery (p < 0.001), but not during the remaining part of the first post-operative week. Bleeding complications were reported by 17 patients (8.5%) in the Betamethasone group and seven (3.5%) in the placebo group (p = 0.028). One month after surgery, 21 out of 173 (12%) in the betamethasone group still had pain, compared to 33 out of 159 (21%) in the placebo arm (p = 0.049). After 1 year, no significant difference in pain was seen.
  
  
  CONCLUSIONS
  A 12 mg betamethasone reduced pain during the first 24 h and at 1 month after inguinal hernia surgery. If combined with diclofenac, however, this dose may increase the risk for bleeding complications.
authors.affiliation: Department of Anesthesiology, Ludvika Hospital, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Simsa
authors.forename: N
authors.initials: N
authors.lastname: Magnusson
authors.forename: M
authors.initials: M
authors.lastname: Hedberg
authors.forename: T
authors.initials: T
authors.lastname: Lorentz
authors.forename: U
authors.initials: U
authors.lastname: Gunnarsson
authors.forename: G
authors.initials: G
authors.lastname: Sandblom
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001623:Betamethasone / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy*; D011184:Postoperative Period; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001623:Betamethasone