Perineural dexamethasone may significantly increase the duration of analgesia after regional blockade, though without dose-response effect.

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• E Albrecht, C Kern, and K R Kirkham.
• Department of Anaesthesia, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
• Anaesthesia. 2015 Jan 1; 70 (1): 71-83.

AbstractWe 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 I2 exceeding 90% for both analyses. Meta-regression did not show an interaction between dose of perineural dexamethasone (4-10 mg) and duration of analgesia (r2 = 0.02, p = 0.54). There were no differences between 4 and 8 mg dexamethasone on subgroup analysis.© 2014 The Association of Anaesthetists of Great Britain and Ireland.

This article appears in the collections: Does dexamethasone safely prolong peripheral nerve blocks?, Regional stuff, and Meta-analyses.

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