SynthesisFrontiers in medicine2023
Comparison of dexmedetomidine and dexamethasone as adjuvants to the ultrasound-guided interscalene nerve block in arthroscopic shoulder surgery: a systematic review and Bayesian network meta-analysis of randomized controlled trials.
Synthesis in Frontiers in medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07099222 (Extended Duration of Peripheral Nerve Blocks With Low, Non-weight-based Adjuncts of Dexamethasone and Dexmedetomidine Compared to Dexamethasone Alone in Orthopedic Surgery), which is not on this map. Cited by 9 papers, 1 of them a synthesis that pooled 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.
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.
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
Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Impact of intraoperative dexmedetomidine on postoperative outcomes in shoulder arthroscopy: a systematic review and meta-analysis.BMC anesthesiology · 2026Pooled it
- Effect of Ultrasound-Guided External Oblique Intercostal Block on Postoperative Recovery After Subxiphoid Video-Assisted Thoracoscopic Thymectomy: A Randomized Controlled Trial.Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2025Trial
- Dexamethasone vs. Dexmedetomidine as Adjuvants to Erector Spinae Plane Block in Total Knee Arthroplasty: A Randomized Double-Blind Controlled Trial.Journal of clinical medicine · 2026Article
- Analgesic effects of dexmedetomidine combined with shoulder nerve blocks before arthroscopy: a meta-analysis of randomized-controlled trials.EFORT open reviews · 2025Article
- An update on regional anesthesia in shoulder surgery: a narrative review.Annals of joint · 2025Review
- Effect of varying doses of dexmedetomidine added to dexamethasone-enhanced TAPB for post-cesarean pain management.Frontiers in medicine · 2025Article
- Research progress of rebound pain after nerve block in arthroscopic rotator cuff repair.Frontiers in medicine · 2025Review
- Review
- A randomized controlled trial evaluating the efficacy of combined dexamethasone and dexmedetomidine as adjuvants to ropivacaine in adductor canal block for postoperative analgesia in total knee arthroplasty.Journal of anaesthesiology, clinical pharmacologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Interscalene block (ISB) is widely regarded as the gold standard treatment for acute pain following arthroscopic shoulder surgery. However, a single injection of a local anesthetic for ISB may not offer sufficient analgesia. Various adjuvants have been demonstrated to prolong the analgesic duration of the block. Hence, this study aimed to assess the relative efficacy of dexamethasone and dexmedetomidine as adjuncts to prolong the analgesic duration for a single- shot ISB. Methods: The efficacy of adjuvants was compared using a network meta-analysis. The methodological quality of the included studies was evaluated using the Cochrane bias risk assessment tool. A comprehensive search of the PubMed, Cochrane, Web of Science, and Embase databases was conducted with a search deadline of March 1, 2023. Various adjuvant prevention randomized controlled trials have been conducted in patients undergoing interscalene brachial plexus block for shoulder arthroscopic surgery. Results: Twenty-five studies enrolling a total of 2,194 patients reported duration of analgesia. Combined dexmedetomidine and dexamethasone (MD = 22.13, 95% CI 16.67, 27.58), dexamethasone administered perineurally (MD = 9.94, 95% CI 7.71, 12.17), high-dose intravenous dexamethasone (MD = 7.47, 95% CI 4.41, 10.53), dexmedetomidine administered perineurally (MD = 6.82, 95% CI 3.43, 10.20), and low-dose intravenous dexamethasone (MD = 6.72, 95% CI 3.74, 9.70) provided significantly longer analgesic effects compared with the control group. Discussion: The combination of intravenous dexamethasone and dexmedetomidine provided the greatest effect in terms of prolonged analgesia, reduced opioid doses, and lower pain scores. Furthermore, peripheral dexamethasone in prolonging the analgesic duration and lowering opioid usage was better than the other adjuvants when used a single medication. All therapies significantly prolonged the analgesic duration and reduced the opioid dose of a single-shot ISB in shoulder arthroscopy compared with the placebo.
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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.