Evidence map›Paper›PMID 34540647›Full record

ReviewAnesthesiology and pain medicine2021

Adjuvant Drugs for Peripheral Nerve Blocks: The Role of Alpha-2 Agonists, Dexamethasone, Midazolam, and Non-steroidal Anti-inflammatory Drugs.

Amber N Edinoff, Garrett M Houk, Shilpa Patil, Harish Bangalore Siddaiah, Aaron J Kaye, Priya Shelvan Iyengar, Elyse M Cornett, Farnad Imani, Kamran Mahmoudi, Adam M Kaye and 2 more

2 registry-linked trialsOpen access · diamondAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Anesthesiology and pain medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 23 papers.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed
8.6field-weighted citation impact, top 1% 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.

NCT06945263 naenrolling by invitationnot on this mapstarted 2025, after this paper: background citation

Rectus Sheath Block and Coadministration of Intravenous Dexamethasone for Analgesia After Pediatric Laparoscopic Appendectomy - A Pilot Study

TypeinterventionalSponsorUniversity of British ColumbiaRan2025 to 2026Enrolled32ConditionsLaparoscopic AppendectomyArmsRectus Sheath Block, Local Anesthetic at the Umbilical Port Site, Intravenous Dexamethasone, Local Anesthetic at the Incision Site
NCT07099222 phase1 / phase2active not recruitingnot on this mapstarted 2024, after this paper: background citation

Extended Duration of Peripheral Nerve Blocks With Low, Non-weight-based Adjuncts of Dexamethasone and Dexmedetomidine Compared to Dexamethasone Alone in Orthopedic Surgery: A Prospective, Single-blind, Randomized Controlled Trial

TypeinterventionalSponsorUniversity of ArizonaRan2024 to 2026Enrolled100ConditionsPostoperative Pain, Nausea and Vomiting, Postoperative, Dizziness, ConstipationArmsLow, non-weight based dose of Dexamethasone and Dexmedetomidine in peripheral nerve blocks, Ropivacaine with low, non weight based Dexamethasone additive
3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 56 citations in OpenAlex.

  1. Trial
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  4. Review
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  7. History of the Nerve Block.Orthopedic reviews · 2024
    Review
  8. Article
  9. Dexmedetomidine as an Adjuvant in Peripheral Nerve Block.Drug design, development and therapy · 2023
    Review
  10. Review
  11. Article
  12. Article
  13. Review
  14. Review
  15. Article
  16. Article
  17. Review
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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 7 institutions in 2 countries.

Amber N EdinoffLouisiana State University Health Science Center Shreveport, Department of Psychiatry and Behavioral Medicine, Shreveport, LA, USA.ORCID https://orcid.org/0000-0001-7436-6206
Garrett M HoukSchool of Medicine, Louisiana State University Shreveport, Shreveport, LA, USA.
Shilpa PatilLouisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, USA.
Harish Bangalore SiddaiahLouisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, USA.
Aaron J KayeMedical University of South Carolina, Department of Anesthesiology and Perioperative Medicine, Charleston, SC, USA.
Priya Shelvan IyengarBrandeis University, Waltham, Massachusetts, USA.
Elyse M CornettLouisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, USA.ORCID https://orcid.org/0000-0001-7961-3931
Farnad ImaniPain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran.ORCID https://orcid.org/0000-0003-0814-0772
Kamran MahmoudiPain Research Center, Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.ORCID https://orcid.org/0000-0002-5077-5280
Adam M KayeThomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA, USA.ORCID https://orcid.org/0000-0002-7224-3322
Richard D UrmanDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA.ORCID https://orcid.org/0000-0002-0516-5977
Alan D KayeLouisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA, USA.ORCID https://orcid.org/0000-0003-2464-0187
Louisiana State University in Shreveport · USUniversity of the Pacific · USAhvaz Jundishapur University of Medical Sciences · IRBrandeis University · USBrigham and Women's Hospital · USIran University of Medical Sciences · IRLouisiana State University Health Sciences Center Shreveport · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Adjuvant drugs for peripheral nerve blocks are a promising solution to acute postoperative pain and the transition to chronic pain treatment. Peripheral nerve blocks (PNB) are used in the brachial plexus, lumbar plexus, femoral nerve, sciatic nerve, and many other anatomic locations for site-specific pain relief. However, the duration of action of a PNB is limited without an adjuvant drug. The use of non-opioid adjuvant drugs for single-shot peripheral nerve blocks (sPNB), such as alpha-2 agonists, dexamethasone, midazolam, and non-steroidal anti-inflammatory drugs, can extend the duration of local anesthetics and reduce the dose-dependent adverse effects of local anesthetics. Tramadol is a weak opioid that acts as a central analgesic. It can block voltage-dependent sodium and potassium channels, cause serotonin release, and inhibit norepinephrine reuptake and can also be used as an adjuvant in PNBs. However, tramadol's effectiveness and safety as an adjuvant to local anesthetic for PNB are inconsistent. The effects of the adjuvants on neurotoxicity must be further evaluated with further studies to delineate the safety in their use in PNB. Further research needs to be done. However, the use of adjuvants in PNB can be a way to help control postoperative pain.

Indexed as

Adjuvant MedicationsAlpha-2 AgonistsDexamethasoneMidazolamNSAIDsPeripheral Nerve BlockPostoperative Pain

Identifiers

PMID34540647
PMCPMC8438706
OpenAlexW3182149369

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.