SynthesisBritish journal of anaesthesia2024
Intravenous versus perineural dexamethasone to prolong analgesia after interscalene brachial plexus block: a systematic review with meta-analysis and trial sequential analysis.
Synthesis in British journal of anaesthesia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effect of dexamethasone on rebound pain and analgesic effects after upper limb surgery under brachial plexus block: a meta-analysis.BMC surgery · 2025Pooled it
- Comparison of Postoperative Analgesic Effects of Intravenous versus Perineural Dexamethasone Injection Combined with Ropivacaine in Thoracoscopy-Guided Thoracic Paravertebral Block for Thoracoscopic Radical Lung Cancer Resection: A Prospective Randomized Controlled Trial.Drug design, development and therapy · 2025Trial
- Comparison of liposomal bupivacaine and bupivacaine hydrochloride intercostal nerve blocks for postoperative analgesia after thoracic surgery: a multicenter, randomized, three arms trial protocol.Annals of medicine · 2026Article
- Article
- Consistent analgesic effect of intravenous dexamethasone on rebound pain after brachial plexus block: a causal machine learning approach.The Korean journal of pain · 2026Article
- 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
- Low-Volume Versus Standard-Volume Pericapsular Nerve Group Block with and Without Dexamethasone for Postoperative Analgesia After Total Hip Arthroplasty: A Randomized Controlled Trial.Journal of clinical medicine · 2026Article
- Regional anesthesia strategies for proximal humerus fracture surgery: anatomical considerations, diaphragm-sparing techniques, and expert perspectives-a narrative review.Langenbeck's archives of surgery · 2026Review
- Comment on: "Perineural dexamethasone effectively prolongs anaesthesic block duration in total hip arthroplasty".International orthopaedics · 2026Article
- Lumbar Erector Spinae Plane Block as a Main Anesthetic Technique versus Spinal Anesthesia Combined with PENG Block for Urgent Intertrochanteric Fracture Surgery in Elderly Patients: Preliminary Results from a Multicenter Pilot Study.Local and regional anesthesia · 2026Article
- Reduced Ropivacaine Volume with Perineural Dexamethasone in PENG Block for Total Hip Arthroplasty: A Randomized Controlled Trial.Journal of clinical medicine · 2025Article
- Transauricular Vagus Nerve Stimulation for Postoperative Analgesia following Arthroscopic Shoulder Surgery: A Double-Blind, Randomized, Placebo-Controlled Trial.Pain and therapy · 2025Article
- Considerations for regional anaesthesia for the shoulder joint - Beyond the C5-C6 nerve roots.Journal of anesthesia and translational medicine · 2025Review
- Opioid-free anaesthesia as a valuable alternative to opioid-based practices: evidence and future challenges.Pain management · 2025Review
- Article
- Article
- Perineural dexamethasone: neurotoxicity or neuroprotection? A systematic review of preclinical evidence.Journal of anesthesia, analgesia and critical care · 2025Review
- Effect of Perineural Dexamethasone as an Adjuvant to Ropivacaine in Rectus Sheath Block for Radical Cystectomy: A Randomized Controlled Trial.Journal of clinical medicine · 2025Article
- Ropivacaine and dexamethasone: Better to separate than mixing together.Indian journal of anaesthesia · 2025Article
- Prolonging peripheral nerve block duration: Current techniques and future perspectives.Acta anaesthesiologica Scandinavica · 2025Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe efficacy of perineural vs intravenous dexamethasone as a local anaesthetic adjunct to increase duration of analgesia could be particular to specific peripheral nerve blocks because of differences in systemic absorption depending on the injection site. Given this uncertainty, we performed a systematic review with meta-analysis and trial sequential analysis comparing dexamethasone administered perineurally or intravenously combined with local anaesthetic for interscalene brachial plexus block.
methodsFollowing a search of various electronic databases, we included 11 trials (1145 patients). The primary outcome was the duration of analgesia defined as the time between peripheral nerve block or onset of sensory blockade and the time to first analgesic request or initial report of pain.
resultsThe primary outcome, duration of analgesia, was greater in the perineural dexamethasone group, with a mean difference (95% confidence interval) of 122 (62-183) min, I
conclusionsThere is low-quality evidence that perineural administration of dexamethasone as a local anaesthetic adjunct increases duration of analgesia by an average of 2 h compared with intravenous injection for interscalene brachial plexus block. Given the limited clinical relevance of this difference, the off-label use of perineural administration, and the risk of drug crystallisation, we recommend intravenous dexamethasone administration. SYSTEMATIC REVIEW PROTOCOL: PROSPERO (CRD42023466147).
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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.