Alarasan 2017.

Methods	Parallel group RCT.
Participants	In India, 60 ASA class I or II participants aged 20‐69 years undergoing elective upper limb surgery (expected duration 60‐120 minutes) with ultrasound‐guided supraclavicular brachial plexus block. Participants with communication difficulties, hypersensitivity to local anaesthetics and dexamethasone, those on sedative medications and perioperative intravenous steroids were excluded from the study.
Interventions	Block All participants received supraclavicular brachial plexus block with bupivacaine 0.5% 20 ml. Dexamethasone/placebo Perineural dexamethasone group: dexamethasone 8 mg perineurally Placebo group: normal saline 2 ml intravenously. Intraoperative anaesthesia/analgesia Diazepam 0.15 mg orally the night before and on the morning of surgery. Postoperative anaesthesia/analgesia Diclofenac 1.5 mg intravenously for VAS > 30.
Outcomes	Outcomes of interest for the review Duration of sensory block defined as the onset of block and appearance of pain requiring analgesia. Duration of motor block defined as the time interval between complete motor paralysis to the compete return of motor power. Adverse events including nausea, vomiting, bradycardia, hypotension, convulsions, haematoma. Other outcomes Onset of block defined as the interval between injection of study drug to complete loss of cold perception and complete paralysis. Severity of pain at 90, 150, 210, 270, 330, 390 and 450 minutes after surgery.
Notes	Funding: Gajira Raja Medical College, Gwalior, Madhya Pradesh, India. Conflicts of interest: none.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	No indication of how random sequence was generated.
Allocation concealment (selection bias)	Unclear risk	No indication of how group allocation was concealed.
Blinding of participants (detection bias)	Unclear risk	No indication whether participants were blinded.
Blinding of personnel (detection bias)	Unclear risk	Anesthesiologist performing the block was blinded, however, no indication whether other personnel were blinded.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	No indication whether outcome assessors were blinded.
Incomplete outcome data (attrition bias) All outcomes	Low risk	No missing outcome data.
Selective reporting (reporting bias)	Low risk	No protocol available. All outcomes were reported as stated in the methods section.
Other bias	Low risk	Appears to be free of any other bias.