Perineural Dexamethasone to Improve Postoperative Analgesia with Peripheral Nerve Blocks: A Meta-Analysis of Randomized Controlled Trials
Background. The overall effect of perineural dexamethasone on postoperative analgesia outcomes has yet to be quantified. The main objective of this quantitative review was to evaluate the effect of perineural dexamethasone as a nerve block adjunct on postoperative analgesia outcomes. Methods. A syst...
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| Veröffentlicht in: | Pain Research and Treatment 2014-01, Vol.2014 (2014), p.43-51 |
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| creator | De Oliveira, Gildasio S. Castro Alves, Lucas J. Nader, Autoun Kendall, Mark C. Rahangdale, Rohit McCarthy, Robert J. |
| description | Background. The overall effect of perineural dexamethasone on postoperative analgesia outcomes has yet to be quantified. The main objective of this quantitative review was to evaluate the effect of perineural dexamethasone as a nerve block adjunct on postoperative analgesia outcomes. Methods. A systematic search was performed to identify randomized controlled trials that evaluated the effects of perineural dexamethasone as a block adjunct on postoperative pain outcomes in patients receiving regional anesthesia. Meta-analysis was performed using a random-effect model. Results. Nine randomized trials with 760 subjects were included. The weighted mean difference (99% CI) of the combined effects favored perineural dexamethasone over control for analgesia duration, 473 (264 to 682) minutes, and motor block duration, 500 (154 to 846) minutes. Postoperative opioid consumption was also reduced in the perineural dexamethasone group compared to control, −8.5 (−12.3 to −4.6) mg of IV morphine equivalents. No significant neurological symptoms could have been attributed to the use of perineural dexamethasone. Conclusions. Perineural dexamethasone improves postoperative pain outcomes when given as an adjunct to brachial plexus blocks. There were no reports of persistent nerve injury attributed to perineural administration of the drug. |
| doi_str_mv | 10.1155/2014/179029 |
| format | Article |
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The overall effect of perineural dexamethasone on postoperative analgesia outcomes has yet to be quantified. The main objective of this quantitative review was to evaluate the effect of perineural dexamethasone as a nerve block adjunct on postoperative analgesia outcomes. Methods. A systematic search was performed to identify randomized controlled trials that evaluated the effects of perineural dexamethasone as a block adjunct on postoperative pain outcomes in patients receiving regional anesthesia. Meta-analysis was performed using a random-effect model. Results. Nine randomized trials with 760 subjects were included. The weighted mean difference (99% CI) of the combined effects favored perineural dexamethasone over control for analgesia duration, 473 (264 to 682) minutes, and motor block duration, 500 (154 to 846) minutes. Postoperative opioid consumption was also reduced in the perineural dexamethasone group compared to control, −8.5 (−12.3 to −4.6) mg of IV morphine equivalents. No significant neurological symptoms could have been attributed to the use of perineural dexamethasone. Conclusions. Perineural dexamethasone improves postoperative pain outcomes when given as an adjunct to brachial plexus blocks. There were no reports of persistent nerve injury attributed to perineural administration of the drug.</description><identifier>ISSN: 2090-1542</identifier><identifier>EISSN: 2090-1550</identifier><identifier>DOI: 10.1155/2014/179029</identifier><identifier>PMID: 25485150</identifier><language>eng</language><publisher>United States: Hindawi Limiteds</publisher><subject>Analgesia ; Analgesics ; Dexamethasone ; Dosage and administration ; Drug therapy ; Neurons ; Pain ; Pain management ; Postoperative pain ; Postoperative period ; Review ; Steroids</subject><ispartof>Pain Research and Treatment, 2014-01, Vol.2014 (2014), p.43-51</ispartof><rights>Copyright © 2014 Gildasio S. De Oliveira Jr. et al.</rights><rights>COPYRIGHT 2014 Hindawi Limited</rights><rights>Copyright © 2014 Gildasio S. De Oliveira Jr. et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</rights><rights>Copyright © 2014 Gildasio S. De Oliveira Jr. et al. 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a578t-baca05bf1cc1004aa462a716e7d1e64afdf773add7a5f94af7fbb63b977c34b93</citedby><cites>FETCH-LOGICAL-a578t-baca05bf1cc1004aa462a716e7d1e64afdf773add7a5f94af7fbb63b977c34b93</cites><orcidid>0000-0002-0239-7756</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4251083/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4251083/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27923,27924,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25485150$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Evers, Stefan</contributor><creatorcontrib>De Oliveira, Gildasio S.</creatorcontrib><creatorcontrib>Castro Alves, Lucas J.</creatorcontrib><creatorcontrib>Nader, Autoun</creatorcontrib><creatorcontrib>Kendall, Mark C.</creatorcontrib><creatorcontrib>Rahangdale, Rohit</creatorcontrib><creatorcontrib>McCarthy, Robert J.</creatorcontrib><title>Perineural Dexamethasone to Improve Postoperative Analgesia with Peripheral Nerve Blocks: A Meta-Analysis of Randomized Controlled Trials</title><title>Pain Research and Treatment</title><addtitle>Pain Res Treat</addtitle><description>Background. The overall effect of perineural dexamethasone on postoperative analgesia outcomes has yet to be quantified. The main objective of this quantitative review was to evaluate the effect of perineural dexamethasone as a nerve block adjunct on postoperative analgesia outcomes. Methods. A systematic search was performed to identify randomized controlled trials that evaluated the effects of perineural dexamethasone as a block adjunct on postoperative pain outcomes in patients receiving regional anesthesia. Meta-analysis was performed using a random-effect model. Results. Nine randomized trials with 760 subjects were included. The weighted mean difference (99% CI) of the combined effects favored perineural dexamethasone over control for analgesia duration, 473 (264 to 682) minutes, and motor block duration, 500 (154 to 846) minutes. Postoperative opioid consumption was also reduced in the perineural dexamethasone group compared to control, −8.5 (−12.3 to −4.6) mg of IV morphine equivalents. No significant neurological symptoms could have been attributed to the use of perineural dexamethasone. Conclusions. Perineural dexamethasone improves postoperative pain outcomes when given as an adjunct to brachial plexus blocks. There were no reports of persistent nerve injury attributed to perineural administration of the drug.</description><subject>Analgesia</subject><subject>Analgesics</subject><subject>Dexamethasone</subject><subject>Dosage and administration</subject><subject>Drug therapy</subject><subject>Neurons</subject><subject>Pain</subject><subject>Pain management</subject><subject>Postoperative pain</subject><subject>Postoperative period</subject><subject>Review</subject><subject>Steroids</subject><issn>2090-1542</issn><issn>2090-1550</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>RHX</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkk1v1DAQhiMEolXpiTuyxAWB0tqxHW84IC3LV1GBFSpna5JMNi5JHOykpfwD_jWOUnZZhIQtazzjZ15_TRQ9ZPSEMSlPE8rEKVMZTbI70WFCMxqHML27nYvkIDr2_pKGJqmQit6PDhIpFpJJehj9XKMzHY4OGvIKv0OLQw3edkgGS87a3tkrJGvrB9ujg8EEb9lBs0FvgFyboSaTQF_jJPARXVh_2djiq39OluQDDhBP-I03ntiKfIautK35gSVZ2W5wtmnC9MIZaPyD6F4VDB7f2qPoy5vXF6t38fmnt2er5XkMUi2GOIcCqMwrVhSMUgEg0gQUS1GVDFMBVVkpxaEsFcgqC76q8jzleaZUwUWe8aPoxazbj3mLZYHhHNDo3pkW3I22YPT-SmdqvbFXWiSS0QUPAk9uBZz9NqIfdGt8gU0DHdrRa5ZyJRVP1bTX47_QSzu68CCBUjQTKhNysaM20KA2XWXDvsUkqpciSYRQjItAnfyDCr3E1hThxyoT4nsJz-aEwlnvHVbbOzKqp-LRU_HouXgC_ejPZ9myv0slAE9noDZdCdfmP2rvZxiMM4PZXXsdqJTKMOicwRK9C3G27wiuJeO_AKsV4PY</recordid><startdate>20140101</startdate><enddate>20140101</enddate><creator>De Oliveira, Gildasio S.</creator><creator>Castro Alves, Lucas J.</creator><creator>Nader, Autoun</creator><creator>Kendall, Mark C.</creator><creator>Rahangdale, Rohit</creator><creator>McCarthy, Robert J.</creator><general>Hindawi Limiteds</general><general>Hindawi Publishing Corporation</general><general>Hindawi Limited</general><scope>188</scope><scope>RHU</scope><scope>RHW</scope><scope>RHX</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7XB</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PADUT</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0239-7756</orcidid></search><sort><creationdate>20140101</creationdate><title>Perineural Dexamethasone to Improve Postoperative Analgesia with Peripheral Nerve Blocks: A Meta-Analysis of Randomized Controlled Trials</title><author>De Oliveira, Gildasio S. ; Castro Alves, Lucas J. ; Nader, Autoun ; Kendall, Mark C. ; Rahangdale, Rohit ; McCarthy, Robert J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a578t-baca05bf1cc1004aa462a716e7d1e64afdf773add7a5f94af7fbb63b977c34b93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Analgesia</topic><topic>Analgesics</topic><topic>Dexamethasone</topic><topic>Dosage and administration</topic><topic>Drug therapy</topic><topic>Neurons</topic><topic>Pain</topic><topic>Pain management</topic><topic>Postoperative pain</topic><topic>Postoperative period</topic><topic>Review</topic><topic>Steroids</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>De Oliveira, Gildasio S.</creatorcontrib><creatorcontrib>Castro Alves, Lucas J.</creatorcontrib><creatorcontrib>Nader, Autoun</creatorcontrib><creatorcontrib>Kendall, Mark C.</creatorcontrib><creatorcontrib>Rahangdale, Rohit</creatorcontrib><creatorcontrib>McCarthy, Robert J.</creatorcontrib><collection>Airiti Library</collection><collection>Hindawi Publishing Complete</collection><collection>Hindawi Publishing Subscription Journals</collection><collection>Hindawi Publishing Open Access Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Research Library China</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pain Research and Treatment</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>De Oliveira, Gildasio S.</au><au>Castro Alves, Lucas J.</au><au>Nader, Autoun</au><au>Kendall, Mark C.</au><au>Rahangdale, Rohit</au><au>McCarthy, Robert J.</au><au>Evers, Stefan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Perineural Dexamethasone to Improve Postoperative Analgesia with Peripheral Nerve Blocks: A Meta-Analysis of Randomized Controlled Trials</atitle><jtitle>Pain Research and Treatment</jtitle><addtitle>Pain Res Treat</addtitle><date>2014-01-01</date><risdate>2014</risdate><volume>2014</volume><issue>2014</issue><spage>43</spage><epage>51</epage><pages>43-51</pages><issn>2090-1542</issn><eissn>2090-1550</eissn><abstract>Background. The overall effect of perineural dexamethasone on postoperative analgesia outcomes has yet to be quantified. The main objective of this quantitative review was to evaluate the effect of perineural dexamethasone as a nerve block adjunct on postoperative analgesia outcomes. Methods. A systematic search was performed to identify randomized controlled trials that evaluated the effects of perineural dexamethasone as a block adjunct on postoperative pain outcomes in patients receiving regional anesthesia. Meta-analysis was performed using a random-effect model. Results. Nine randomized trials with 760 subjects were included. The weighted mean difference (99% CI) of the combined effects favored perineural dexamethasone over control for analgesia duration, 473 (264 to 682) minutes, and motor block duration, 500 (154 to 846) minutes. Postoperative opioid consumption was also reduced in the perineural dexamethasone group compared to control, −8.5 (−12.3 to −4.6) mg of IV morphine equivalents. No significant neurological symptoms could have been attributed to the use of perineural dexamethasone. Conclusions. Perineural dexamethasone improves postoperative pain outcomes when given as an adjunct to brachial plexus blocks. There were no reports of persistent nerve injury attributed to perineural administration of the drug.</abstract><cop>United States</cop><pub>Hindawi Limiteds</pub><pmid>25485150</pmid><doi>10.1155/2014/179029</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-0239-7756</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Analgesia Analgesics Dexamethasone Dosage and administration Drug therapy Neurons Pain Pain management Postoperative pain Postoperative period Review Steroids |
| title | Perineural Dexamethasone to Improve Postoperative Analgesia with Peripheral Nerve Blocks: A Meta-Analysis of Randomized Controlled Trials |
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