• Jonathan J S Ambler, David A Zideman, and Charles D Deakin.
• Shackleton Department of Anaesthetics, Southampton University Hospitals NHS Trust, Tremona Road, Southampton SO16 6YD, UK. jjsa@amblers.org
• Resuscitation. 2005 May 1; 65 (2): 179-84.

IntroductionCutaneous 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.Materials And MethodsTwo 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.ResultsThe 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.ConclusionTopical 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.

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