Table 2.
Summary of meta-analyses investigating the effects of dexamethasone as an additive for peripheral nerve blockade on sensory block duration
| Included trials (no. of subjects) | Dexamethasone dose (mg) | Local anaesthetics | Mean difference (95% confidence interval) in sensory block duration (min) | Final conclusion | |
|---|---|---|---|---|---|
| Choi and colleagues3 (2014) | 9 (801) | 4–10 | Long-acting | +576 (522–631) | Dexamethasone prolongs sensory blockade duration; effect of systemic administration must be evaluated |
| Albrecht and colleagues1 (2015) | 29 (1695) | 4–10 | Short-, medium-, and long-acting | +233 (172–295) with short- and medium-acting LA + 488 (419–557) with long-acting LA | Interpret results with caution because of extreme heterogeneity of studies |
| Huynh and colleagues5 (2015) | 12 (1054) | 4–10 | Medium- and long-acting | +351 (288–413) | Significant prolongation of duration of peripheral nerve blockade |
| Zhao and colleagues7 (2017) | 10 (749) | 4–10 | With or without epinephrine | +2 (−4 to 14) without epinephrine +238 (160–316) with epinephrine |
Increases duration of sensory blockade only when epinephrine is also added |
| Baeriswyl and colleagues2 (2017) | 11 (914) | 4–10 | Short- and long-acting | +180 (84–270) | Sensory blockade increased by 21% with bupivacaine and 12% with ropivacaine, moderate quality of evidence |
| Pehora and colleagues6 (2017) | 35 (2702) | No information | Short-, medium-, and long-acting | +402 (332–471) | Low to moderate quality of evidence, i.v. dexamethasone increases block duration vs placebo, onging trials may change these results |
| Heesen and colleagues4 (2018) | 10 (783) | 5–10 | Short- and long-acting | +241 (87–394) | Low quality evidence |