title: The effect of a preoperative single-dose methylprednisolone on postoperative pain after abdominal hysterectomy: a randomized controlled trial.
abstract: OBJECTIVE
  Methylprednisolone has been shown to have analgesic effects after orthopedic surgery. The objective of this trial was to compare the effect of 125 mg methylprednisolone with placebo on postoperative pain after abdominal hysterectomy.
  
  
  METHODS
  In this randomized double-blinded placebo-controlled trial women scheduled for elective abdominal hysterectomy (n=59) were randomized to preoperatively receive either 125 mg methylprednisolone or saline intravenously. Primary outcome was postoperative pain measured on a 0.0-10.0 visual analog scale and assessed at rest and during mobilization repeatedly the first 24h and daily on the 2nd to 7th postoperative day. Secondary outcomes were postoperative use of opioids and antiemetics, vomiting, C-reactive protein levels, and time to mobilization and discharge. Repeated measures including the primary outcome were analyzed with linear mixed models.
  
  
  RESULTS
  Forty-nine cases were analyzed (methylprednisolone n=25, placebo n=24). Pain scores were significantly higher in the methylprednisolone group compared to the placebo group during mobilization (0.79 [95% confidence intervals (CI) 0.07-1.50] P=0.03) but not at rest (0.55 [95% CI: -0.06 to 1.16] P=0.08). There was no difference between the methylprednisolone and placebo group regarding use of opioids (P=0.24) and antiemetics (P=0.14), number of vomits (P=0.26), and time to mobilization (P=0.24) and discharge (P=0.28). C-reactive protein levels were significantly higher in the placebo group (P=0.01).
  
  
  CONCLUSIONS
  This trial showed no beneficial effect of methylprednisolone on postoperative pain after abdominal hysterectomy. Methylprednisolone significantly lowered postoperative CRP levels.
  
  
  BACKGROUND
  ClinicalTrial.gov: www.clinicaltrials.gov: NCT01106547.
authors: Department of Obstetrics and Gynecology, University of Copenhagen, Holbæk Hospital, Denmark. Electronic address: aabakke@gmail.com.
authors: Anna J M
authors: AJ
authors: Aabakke
authors: Department of Anesthesiology, University of Copenhagen, Holbæk Hospital, Denmark.
authors: Lars B
authors: LB
authors: Holst
authors: Department of Obstetrics and Gynecology, University of Copenhagen, Holbæk Hospital, Denmark.
authors: Jørgen C
authors: JC
authors: Jørgensen
authors: The Research Unit Women's and Children's Health, The Juliane Marie Center, Copenhagen University Hospital, Denmark; Department of Obstetrics and Gynecology, Aarhus University Hospital, Denmark.
authors: Niels J
authors: NJ
authors: Secher
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000378:metabolism; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007902:Length of Stay; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D020250:Postoperative Nausea and Vomiting; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000601:surgery*
chemical_list: D000701:Analgesics, Opioid; D000893:Anti-Inflammatory Agents; D002097:C-Reactive Protein; D008775:Methylprednisolone
keywords: Glucocorticoids; Hysterectomy; Methylprednisolone; Pain; Postoperative