Golwala 2009.

Methods	Parallel group RCT.
Participants	In India, 60 ASA class I‐II participants undergoing elective or emergency upper limb surgery with supraclavicular brachial plexus block were included. Participants with a history or uncontrolled diabetes, renal or liver disease, circulatory instability, pregnancy, peptic ulcer disease, allergy to local anaesthetics or receiving long‐term steroid therapy were excluded.
Interventions	Block All participants underwent landmark‐guided supraclavicular block with lidocaine 2 % 15 ml + bupivacaine 0.5% 15 ml + adrenaline 1:200,000 Dexamethasone/placebo Dexamethasone group: dexamethasone 8 mg perineurally. Placebo group: normal saline 2 ml perineurally. Intraoperative anaesthesia/analgesia Midazolam IV 1 mg was administered after the block. Postoperative analgesia Diclofenac IM 1.5 mg/kg was administered when VAS was 5 or greater.
Outcomes	Outcomes of interest for the review Intensity of postoperative pain measured on an 11‐point VAS every 3 hours after surgery. Duration of sensory block defined as the time from drug injection in brachial plexus to VAS = 5. Incidence of side effects in the intraoperative and postoperative period. Other outcomes Onset of sensory block defined as dull sensation along any nerve distrubution. Onset of motor block defined as the time when the patient felt heaviness on abduction of arm at the shoulder.
Notes	Duration of block was reported as a range without any measure of central tendency. Pain scores were reported up to six hours in the placebo group and 15 hours in the dexamethasone group, therefore the data for this study could not be included in the meta‐analysis. Incidence of side effects was the only outcome that could be included in the analysis. Funding: no information provided. Conflicts of interest: no information provided.
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 treatment allocation was concealed.
Blinding of participants (detection bias)	Unclear risk	No indication whether participants were blinded.
Blinding of personnel (detection bias)	Unclear risk	No indication whether 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)	High risk	No protocol available. Pain scores were reported up to six hours in the placebo group and up to 15 hours in the dexamethasone group.
Other bias	Low risk	Appears to be free of any other bias.