Cochrane · systematic review · CD011770
Dexamethasone as an adjuvant to peripheral nerve block
Pehora, C, Pearson, AME, Kaushal, A, et al. · Cochrane Database of Systematic Reviews · 2017 · Cochrane Library
AnaesthesiaAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
15
current version
GRADE rated
13
No studies
2
Included studies
NR
No studies 2 · 13.3%Ungraded 0 · 0%Very low 2 · 13.3%Low 8 · 53.3%Moderate 3 · 20%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Perineural dexamethasone versus placebo
Population: participants undergoing surgery with peripheral nerve block
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Duration of sensory block (we included all studies describing duration of sensory block, regardless of how it was described) Perineural dexamethasone vs placebo | no estimate extracted | 27 studies · 1625 participants | Low Downgraded: risk of bias, inconsistency |
Incidence of serious adverse events (we used the NIH definition of adverse events. A serious event includes death, a life‐threatening event that requires hospitalization or prolonged hospitalization, disability or congenital anomaly) Perineural dexamethasone vs placebo | no estimate extracted | 7 studies · 620 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Postoperative pain intensity at 12 hours (assessed by pain scores on an 11‐point VAS) Perineural dexamethasone vs placebo | no estimate extracted | 5 studies · 257 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Postoperative pain intensity at 24 hours. (assessed by pain scores on an 11‐point VAS) Perineural dexamethasone vs placebo | no estimate extracted | 9 studies · 469 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Postoperative pain intensity at 48 hours (assessed by pain scores on an 11‐point VAS) Perineural dexamethasone vs placebo | no estimate extracted | 3 studies · 296 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Intravenous dexamethasone versus placebo
Population: participants undergoing surgery with peripheral nerve block
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Duration of sensory block (we included all studies describing duration of sensory block regardless of how it was described) Intravenous dexamethasone vs placebo | no estimate extracted | 8 studies · 499 participants | Moderate Downgraded: inconsistency |
Incidence of serious adverse events (we used the NIH definition of adverse events. A serious event includes death, a life‐threatening event that requires hospitalization or prolonged hospitalization, disability or congenital anomaly) Intravenous dexamethasone vs placebo | no estimate extracted | NR | No studies |
Postoperative pain intensity at 12 hours (measured using pain scores on an 11‐point VAS) Intravenous dexamethasone vs placebo | no estimate extracted | 3 studies · 162 participants | Low Downgraded: imprecision, inconsistency |
Postoperative pain intensity at 24 hours (measured using pain scores on an 11‐point VAS) Intravenous dexamethasone vs placebo | no estimate extracted | 5 studies · 257 participants | Low Downgraded: imprecision, inconsistency |
Postoperative pain intensity at 48 hours (measured using pain scores on an 11‐point VAS) Intravenous dexamethasone vs placebo | no estimate extracted | 3 studies · 172 participants | Low Downgraded: imprecision, inconsistency |
Perineural versus intravenous dexamethasone
Population: peripheral nerve block
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Duration of sensory block (we included all studies describing duration of sensory block regardless of how it was described) Perineural vs intravenous dexamethasone | no estimate extracted | 9 studies · 720 participants | Moderate Downgraded: inconsistency |
Incidence of serious adverse events (we used the NIH definition of adverse events. A serious event includes death, a life‐threatening event that requires hospitalization or prolonged hospitalization, disability or congenital anomaly) Perineural vs intravenous dexamethasone | no estimate extracted | NR | No studies |
Postoperative pain intensity at 12 hours (measured using pain scores on an 11‐point VAS) Perineural vs intravenous dexamethasone | no estimate extracted | 3 studies · 217 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Postoperative pain intensity at 24 hours (measured using pain scores on an 11‐point VAS) Perineural vs intravenous dexamethasone | no estimate extracted | 5 studies · 309 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Postoperative pain intensity at 48 hours (measured using pain scores on an 11‐point VAS) Perineural vs intravenous dexamethasone | no estimate extracted | 3 studies · 227 participants | Low Downgraded: risk of bias, imprecision, inconsistency |