The effect of topical non-steroidal anti-inflammatory cream on the incidence and severity of cutaneous burns following external DC cardioversion

Abstract

Introduction: Cutaneous burns are a common cause of morbidity following direct current (DC) cardioversion. We designed a study to determine whether the application of non-steroidal anti-inflammatory cream prior to cardioversion reduces their incidence and severity. Materials and methods: Two hours before elective DC cardioversion, we randomised 55 patients to receive ibuprofen 5% cream or placebo cream over sternal and apical pad sites, with patients acting as their own controls. Two hours after cardioversion an independent blinded observer measured skin temperature, erythema index, and minimum sensory and pain detection thresholds at sternal and apical pad sites. Visual analogue pain score (VAS) for each site was recorded at 2 h and 24 h post-cardioversion. Results: There was a statistically significant difference between pain measured by VAS, skin temperature and pain detection threshold measured at pad sites with pre-applied ibuprofen 5% cream and those with pre-applied aqueous cream, after elective DC cardioversion. Conclusion: Prophylactic application of topical ibuprofen 5% cream 2 h prior to elective DC cardioversion reduces pain and inflammation. Consideration should be given to use of prophylactic application of topical ibuprofen as routine treatment for elective DC cardioversion.