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Research Article: Optimal dose of perineural dexamethasone for the prolongation of analgesia for peripheral nerve blocks: protocol for a systematic review and meta-analysis

Date Published: 2023-07-19

Abstract:
Introduction Perineural use of dexamethasone is demonstrated to extend the analgesia duration of peripheral nerve blocks (PNB), but its optimal dose remains unclear. This systematic review and meta-analysis aims to determine the optimal dose of perineural dexamethasone in the prolongation of analgesia for PNB. Methods and analysis PubMed, EMBASE, the Cochrane Central Register of Controlled Trials and Web of Science will be searched from their inception to 1 March 2023. Language will be restricted to English. Randomised controlled trials that compared the efficacy and safety of different doses of perineural dexamethasone for PNB in adult patients will be included. Retrospective studies, reviews, meta-analyses, case reports, conference abstracts, comments and studies regarding paediatric surgeries will be excluded. The duration of analgesia will be defined as the primary outcome. Secondary outcomes will include pain scores, the total analgesic requirement over 48 hours and the incidence of adverse effects. Two reviewers will independently perform the study selection, data extraction and quality assessment. RevMan V.5.3 software will be used for data analysis. The quality of evidence will be assessed using the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Ethics and dissemination No ethical approval is required. The results of this study will be submitted to peer-reviewed journals. PROSPERO registration number CRD42022385672.

Introduction:
Peripheral nerve blocks (PNB) are widely used for anaesthesia and/or analgesia; however, the analgesic effects of single-shot PNB last only for a few hours. 1 Several adjuvants have been used to prolong the analgesic duration of PNB, including intravenous or perineural injection of dexamethasone, dexmedetomidine and opioids. 2 3 Dexamethasone is the most commonly used adjuvant for PNB. 4 5 Perineural dexamethasone is used more commonly for PNB than the intravenous route, and a previous meta-analysis suggested that…

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