Incorporating Dexamethasone with Local Anesthetics in Single-shot Nerve Blocks: An Integrative Review
View File(s)
Prolonging the duration of analgesia in single-shot nerve blocks (SNBs) continues to be a problem in regional anesthesia. Both IV and perineural dexamethasone have proven to be effective in prolonging the duration of analgesia in SNBs.
Objective: The purpose of this integrative review was to determine how IV and perineural dexamethasone effect duration of analgesia, pain scores, opioid consumption, and complications in patients undergoing SNB.
Methods: An integrative review that included 12 peer-reviewed randomized-controlled trials (RCTs) and one meta-analysis was performed.
Results: The results of the integrative review found that perineural dexamethasone prolonged the duration of analgesia, reduced pain scores, and reduced opioid consumption to a greater extent than IV dexamethasone. IV dexamethasone prolonged the duration of analgesia to a greater extent than local anesthetic with saline and local anesthetic alone. There were no major complications associated with the use of dexamethasone in SNBs.
Conclusions: Perineural dexamethasone is a more effective adjunct in prolonging the duration of analgesia in SNBs compared to IV dexamethasone. IV dexamethasone is an effective, alternative adjunct that can be used to prolong the duration of analgesia in SNBs.
| Type | Other Graduate Paper |
| Acquisition | Proxy-submission |
| Review Type | Faculty Approved: Degree-based Submission |
| Format | Text-based Document |
| Evidence Level | Literature Review |
| Research Approach | Translational Research/Evidence-based Practice |
| Keywords | intravenous dexamethasone; perineural dexamethasone; single-shot nerve block; peripheral nerve block |
| CINAHL Subject(s) | Dexamethasone--Administration and Dosage; Administration, Intravenous; Nerve Block--Methods; Anesthetics, Local; Anesthesia Nursing |
| Grantor | Bryan College of Health Sciences |
| Advisor | Pecka, Shannon |
| Level | Doctoral – Other |
| Year | 2018 |
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Related items
Showing items related by title, author, creator and subjects.
-
The Implications of Local Anesthetic Volume in Adductor Canal Blockade: An Integrative Review
(2018-05-17)Introduction: Maintaining patient safety is of utmost concern for anesthesia providers. The adductor canal block, a peripheral nerve block identified as a motor-sparing sensory block, may decrease fall risk and associated ... -
Effectiveness of inhaled albuterol delivery methods in adult intubated patients: An integrative review
(2017-07-06)The purpose of this integrative review is to critically appraise the available literature related to effectiveness of albuterol delivery methods for the intubated patient undergoing general anesthesia and to make recommendations ... -
Efficacy of pre-procedural ultrasound in facilitating neuraxial anesthetics: An integrative review
(2017-06-26)The purpose of this integrative review is to investigate the efficacy of pre-procedural ultrasound examination to facilitate neuraxial anesthesia techniques and its impact on first attempt success rates, number of attempts ... -
Dexamethasone as an adjunct to peripheral nerve block for extended analgesia
A total shoulder arthroplasty (TSA) is a common orthopedic procedure that is associated with severe postoperative pain. An interscalene block (ISB) is the standard peripheral nerve block (PNB) for this surgery as it results ... -
Modified pectoral nerve block for unilateral mastectomy
General anesthesia combined with opioid therapy is the most common anesthetic technique used for patients undergoing breast cancer surgery; however, inhaled anesthetics and opioids are notorious offenders of a fragile ...
