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A systematic review and meta‐analysis of perineural dexamethasone for peripheral nerve blocks
Author(s) -
Albrecht E.,
Kern C.,
Kirkham K. R.
Publication year - 2015
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.12823
Subject(s) - dexamethasone , medicine , peripheral nerve , peripheral , meta analysis , anesthesia , blockade , subgroup analysis , local anaesthetic , anatomy , receptor
Summary We systematically reviewed the safety and efficacy of perineural dexamethasone as an adjunct for peripheral nerve blockade in 29 controlled trials of 1695 participants. We grouped trials by the duration of local anaesthetic action (short‐ or medium‐ vs long‐term). Dexamethasone increased the mean (95% CI) duration of analgesia by 233 (172–295) min when injected with short‐ or medium‐term action local anaesthetics and by 488 (419–557) min when injected with long‐term action local anaesthetics, p < 0.00001 for both. However, these results should be interpreted with caution due to the extreme heterogeneity of results, with I 2 exceeding 90% for both analyses. Meta‐regression did not show an interaction between dose of perineural dexamethasone (4–10 mg) and duration of analgesia (r 2 = 0.02, p = 0.54). There were no differences between 4 and 8 mg dexamethasone on subgroup analysis.