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Analgesic Effects of Dexamethasone in Burn Injury
  1. Mads U. Werner, M.D., Ph.D.,
  2. Birgit Lassen, R.N.A. and
  3. Henrik Kehlet, M.D., Ph.D.
  1. From the Acute Pain Service, Departments of Anesthesiology and Surgical Gastroenterology, Hvidovre University Hospital, Copenhagen, Denmark.
  1. Reprint requests: Mads U. Werner, M.D., Ph.D., Department of Anesthesiology 532, University Hospital, DK 2650 Hvidovre, Denmark. E-mail:


Background and Objectives Glucocorticoids are well-known adjuvant analgesics in certain chronic pain states. There is, however, a paucity of data on their analgesic efficacy in acute pain. Therefore, the aim of the study was to examine the analgesic effects of dexamethasone in a validated burn model of acute inflammatory pain in humans.

Methods Twenty-two volunteers were investigated in a double-blind, randomized, placebo-controlled cross-over study. Intravenous dexamethasone 8 mg or placebo was administered on 2 separate study days. Two hours after drug administration, a first-degree burn injury was produced on the medial aspect of the nondominant calf (12.5 cm2, 47°C for 7 minutes). Quantitative sensory testing included pain ratings to thermal and mechanical stimuli (visual analog scale [VAS]), assessments of thermal and mechanical detection thresholds, and areas of allodynia and secondary hyperalgesia.

Results The burn injury induced significant increases in erythema (P < .0001) and hyperalgesia (P < .001) in both groups. Pain ratings and development of tactile allodynia during the burn did not differ between dexamethasone and placebo treatments (P > .6). There were no significant differences between treatments in regard to skin erythema (P > .8), thermal or mechanical thresholds (P > .2), thermal or mechanical pain response (P > .2), or mechanical secondary hyperalgesia (P > .2). Dexamethasone had no analgesic effects in normal skin.

Conclusions The study indicates that systemic administration of dexamethasone 2 hours before a burn injury does not reduce the inflammatory-mediated changes in quantitative sensory thresholds, pain perception, or skin erythema in humans.

  • Acute pain
  • Glucocorticoids
  • Human
  • Hyperalgesia
  • Thermal injury

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  • Supported by grants from the Danish Medical Research Council No. 9902757, and the John and Birthe Meyer Foundation.