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.

CONCLUSION:

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: J Simsa, N Magnusson, M Hedberg, T Lorentz, U Gunnarsson, G Sandblom
• Journal: European journal of pain (London, England) (Eur J Pain) Vol. 17 Issue 10 Pg. 1511-6 (Nov 2013) ISSN: 1532-2149 [Electronic] England
• PMID: 23712446 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
• Copyright: © 2013 European Federation of International Association for the Study of Pain Chapters.

Chemical References

• Betamethasone

Topics

• Adolescent
• Adult
• Aged
• Betamethasone (adverse effects, therapeutic use)
• Female
• Follow-Up Studies
• Hernia, Inguinal (surgery)
• Humans
• Male
• Middle Aged
• Nausea (chemically induced)
• Pain Measurement (methods)
• Pain, Postoperative (drug therapy)
• Postoperative Period
• Risk Factors
• Treatment Outcome
• Young Adult