Steroid Prophylaxis and Local Effects of Green Pit Viper Bite

Abstract

Background and Objective: The recommendation of using prophylactic steroids to decrease local effects of
venomous snake bite is controversial. There is no scientific data to support the benefit of this recommendation. We
conducted a randomized controlled trial to determine the benefits of steroid prophylaxis on the local effects of
venomous snake bites.
Material and Method: A double blind randomized controlled trial was performed during March 2004 and
October 2004. Patients were randomized into 2 groups: the prednisolone (0.5mg/kg single dose) group (n=17) and
the placebo group (n=17). The inclusion criteria included: patients bitten by the green pit viper and could identify
the snake; bite time within 6 hours; no previous wound manipulation; and age over 12 years. The exclusion criteria
included: evidence of abnormal bleeding (systemic bleeding, or minor bleeding such as petechial hemorrhage, or
ecchymosis) with abnormal venous clotting times (> 30 minutes). The outcomes compared included swelling scores,
pain scores, presence of skin blebs, skin necrosis, itching and numbness. All outcomes were compared on initial
presentation, and 24 hours, 48 hours, 72 hours, and 7 days after presentation. Statistical analysis was performed using
the SPSS® software version 10.0. P-values less than 0.05 were considered statistically significant.
Results: 34 patients (18 male and 16 female) were bitten by the green pit viper between March 2004 and
October 2004. There were no significant (P> 0.05) differences in the swelling scores, pain scores, presence of skin
blebs, skin necrosis, itching, and numbness between both groups.
Conclusion: No benefit of prophylactic steroids for decreasing local effects of green pit viper bite could be
demonstrated in the present study.