Incorporating Dexamethasone with Local Anesthetics in Single-shot Nerve Blocks: An Integrative Review
Handle
http://hdl.handle.net/10755/624151Repository Posting Date
2018-05-17T16:48:29ZAuthor(s)
Hilsabeck, Kyle G.Type
Other Graduate PaperFormat
Text-based DocumentLevel of Evidence
Literature ReviewResearch Approach
Translational Research/Evidence-based PracticeKeywords
intravenous dexamethasone; perineural dexamethasone; single-shot nerve block; peripheral nerve blockCINAHL Headings
Dexamethasone--Administration and Dosage; Administration, Intravenous; Nerve Block--Methods; Anesthetics, Local; Anesthesia NursingAbstract
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.
