Evidence map›Paper›PMID 33598889›Full record

Trial reportCanadian journal of anaesthesia = Journal canadien d'anesthesie2021

Analgesic duration of interscalene block after outpatient arthroscopic shoulder surgery with intravenous dexamethasone, intravenous dexmedetomidine, or their combination: a randomized-controlled trial.

Daniel Rodrigues, Ryan J J Amadeo, Scott Wolfe, Linda Girling, Faylene Funk, Kelsi Fidler, Holly Brown, Jeff Leiter, Jason Old, Peter MacDonald and 2 more

Registry-linked trialOpen access · bronzeAbstract readRandomized Controlled TrialEquivalence Trial
PubMed Publisher
In one paragraph

Trial report in Canadian journal of anaesthesia = Journal canadien d'anesthesie, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03270033 (Analgesic Duration of Interscalene Block After Outpatient Arthroscopic Shoulder Surgery With Intravenous Dexamethasone, Dexmedetomidine or Their Combination), which is not on this map. Cited by 11 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 3 pooled it
2.9field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03270033 phase4completednot on this map

Analgesic Duration of Interscalene Block After Outpatient Arthroscopic Shoulder Surgery With Intravenous Dexamethasone, Dexmedetomidine or Their Combination: A Randomized Controlled Trial

TypeinterventionalSponsorUniversity of ManitobaRan2017 to 2018Enrolled198ConditionsPain, Postoperative, Shoulder Joint Disorder, Ambulatory Surgical Procedures, Brachial Plexus BlockArmsDexamethasone, Dexmedetomidine
3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Impact of Dexmedetomidine on Analgesia and Inflammatory Response in Knee Surgery: A Study of IPACK and ACB Techniques.Medical science monitor : international medical journal of experimental and clinical research · 2025
    Trial
  5. Trial
  6. Trial
  7. Trial
  8. Article
  9. Review
  10. Article
  11. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 2 institutions in 1 country.

Daniel RodriguesDepartment of Anesthesia and Perioperative Medicine, University of Manitoba, 2nd Floor, Harry Medovy House, 671 William Ave., Winnipeg, MB, R3E 0Z2, Canada.
Ryan J J AmadeoDepartment of Anesthesia and Perioperative Medicine, University of Manitoba, 2nd Floor, Harry Medovy House, 671 William Ave., Winnipeg, MB, R3E 0Z2, Canada.
Scott WolfeDepartment of Anesthesia and Perioperative Medicine, University of Manitoba, 2nd Floor, Harry Medovy House, 671 William Ave., Winnipeg, MB, R3E 0Z2, Canada.
Linda GirlingDepartment of Anesthesia and Perioperative Medicine, University of Manitoba, 2nd Floor, Harry Medovy House, 671 William Ave., Winnipeg, MB, R3E 0Z2, Canada.
Faylene FunkDepartment of Anesthesia and Perioperative Medicine, University of Manitoba, 2nd Floor, Harry Medovy House, 671 William Ave., Winnipeg, MB, R3E 0Z2, Canada.
Kelsi FidlerDepartment of Anesthesia and Perioperative Medicine, University of Manitoba, 2nd Floor, Harry Medovy House, 671 William Ave., Winnipeg, MB, R3E 0Z2, Canada.
Holly BrownDepartment of Orthopedic Surgery, University of Manitoba, Winnipeg, MB, Canada.
Jeff LeiterDepartment of Orthopedic Surgery, University of Manitoba, Winnipeg, MB, Canada.
Jason OldDepartment of Orthopedic Surgery, University of Manitoba, Winnipeg, MB, Canada.
Peter MacDonaldDepartment of Orthopedic Surgery, University of Manitoba, Winnipeg, MB, Canada.
Brenden DufaultGeorge and Fay Yee Centre for Healthcare Innovation, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Thomas C MutterDepartment of Anesthesia and Perioperative Medicine, University of Manitoba, 2nd Floor, Harry Medovy House, 671 William Ave., Winnipeg, MB, R3E 0Z2, Canada. tmutter@exchange.hsc.mb.ca.ORCID http://orcid.org/0000-0003-1614-7237
University of Manitoba · CAGeorge & Fay Yee Centre for Healthcare Innovation · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeBoth intravenous dexamethasone and dexmedetomidine prolong the analgesic duration of interscalene blocks (ISB) after arthroscopic shoulder surgery. This study compared their relative effectiveness and the benefit of their use in combination.

methodsThis single-centre, double-blinded, parallel three-group superiority trial randomized 198 adult patients undergoing ambulatory arthroscopic shoulder surgery. Patients received preoperative ISB with 30 mL 0.5% bupivacaine and 50 µg dexmedetomidine or 4 mg dexamethasone or both of these agents as intravenous adjuncts. The primary outcome was analgesic block duration. Secondary outcomes included the quality of recovery 15 score (range: 0-150) on day 1 and postoperative neurologic symptoms in the surgical arm.

resultsBlock durations (n = 195) with dexamethasone (median [range], 24.5 [2.0-339.5] hr) and both adjuncts (24.0 [1.5-157.0] hr) were prolonged compared with dexmedetomidine (16.0 [1.5-154.0] hr). When analyzed by linear regression after an unplanned log transformation because of right-skewed data, the corresponding prolongations of block duration were 59% (95% confidence interval [CI], 28 to 97) and 46% (95% CI, 18 to 80), respectively (both P < 0.001). The combined adjuncts were not superior to dexamethasone alone (-8%; 95% CI, -26 to 14; P = 0.42). Median [IQR] quality of recovery 15 scores (n = 197) were significantly different only between dexamethasone (126 [79-149]) and dexmedetomidine (118.5 [41-150], P = 0.004), but by an amount less than the 8-point minimum clinically important difference.

conclusionDexamethasone is superior to dexmedetomidine as an intravenous adjunct for prolongation of bupivacaine-based ISB analgesic duration. There was no additional benefit to using both adjuncts in combination.

trial registrationwww.clinicaltrials.gov (NCT03270033); registered 1 September 2017.

Indexed as

Brachial Plexus BlockDexmedetomidineAdultAnalgesicsAnesthetics, LocalArthroscopyDexamethasoneDouble-Blind MethodHumansOutpatientsPostoperative PainShoulderAnalgesicsAnesthetics, LocalDexamethasoneDexmedetomidineanalgesiadexamethasonedexmedetomidineinterscaleneshoulder

Identifiers

PMID33598889
OpenAlexW3132929549

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.