Incorporating Dexamethasone with Local Anesthetics in Single-shot Nerve Blocks: An Integrative Review
Repository Posting Date2018-05-17T16:48:29Z
Author(s)Hilsabeck, Kyle G.
TypeOther Graduate Paper
Level of EvidenceLiterature Review
Research ApproachTranslational Research/Evidence-based Practice
Keywordsintravenous dexamethasone; perineural dexamethasone; single-shot nerve block; peripheral nerve block
CINAHL HeadingsDexamethasone--Administration and Dosage; Administration, Intravenous; Nerve Block--Methods; Anesthetics, Local; Anesthesia Nursing
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.