Exploring the Additive or Synergistic Effects of the Systemic and Perineural Routes of Dexamethasone as Adjuncts to Supraclavicular Block: A Randomized Controlled Trial
Authors' conclusion
Combining the intravenous and perineural dexamethasone routes does not yield an additive or synergistic effect on the characteristics and analgesic effects of supraclavicular block.
Study context
- Population
- Adults having distal radius open reduction and internal fixation and/or carpometacarpal arthroplasty under supraclavicular blockincluded in the analysis
- Participants
- 104 adults
- Comparison
- IV dexamethasone vs IV plus perineural dexamethasone vs no dexamethasone (control) as adjuncts to supraclavicular block
- Intravenous dexamethasonen = 37
- Intravenous plus perineural dexamethasonen = 34
- Controln = 33reference
- Primary endpoint
- Sensory block duration
Primary result
As reported in the abstract
Mean difference, h (95% CI)P value
Intravenous dexamethasone vs Control
4.5(1.3–7.7)
P = 0.006Intravenous plus perineural dexamethasone vs Control
3.8(0.8–6.8)
P = 0.015Intravenous dexamethasone vs Intravenous plus perineural dexamethasone
0.7(−2.5 to 3.9)
P = 0.670Secondary outcomes
24-h pain scores, opioid consumption and rebound pain
- Both dexamethasone groups similarly reduced 24-h pain scores and opioid consumption and decreased rebound pain incidence vs control
All outcomes examined
- Adding perineural to IV dexamethasone yielded no incremental benefit in any outcome
Original publication
Exploring the Additive or Synergistic Effects of the Systemic and Perineural Routes of Dexamethasone as Adjuncts to Supraclavicular Block: A Randomized Controlled Trial. Anesthesiology. Published 4 March 2025. doi:10.
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