| Title |
Perineural versus intravenous dexamethasone as an adjuvant in regional anesthesia: a systematic review and meta-analysis
|
|---|---|
| Published in |
Journal of Pain Research, July 2017
|
| DOI | 10.2147/jpr.s138212 |
| Pubmed ID | |
| Authors |
Wen-Ling Zhao, Xiao-Feng Ou, Jin Liu, Wen-Sheng Zhang |
| Abstract |
Dexamethasone is a common adjuvant for local anesthetics in regional anesthesia, but the optimal route of administration is controversial. Therefore, we did a systematic review and meta-analysis of randomized controlled trials to assess the effect of perineural versus intravenous dexamethasone on local anesthetic regional nerve-blockade outcomes. Medline (through PubMed), Embase, Cochrane, Web of Science, and Biosis Previews databases were systematically searched (published from inception of each database to January 1, 2017) to identify randomized controlled trials. The data of the selected trials were statistically analyzed to find any significant differences between the two modalities. The primary outcome was the duration of analgesia. Secondary outcomes included duration of motor block, postoperative nausea and vomiting, and postoperative analgesic dose at 24 hours. We conducted a planned subgroup analysis to compare the effects between adding epinephrine or not. Ten randomized controlled trials met the inclusion criteria of our analysis, with a total of 749 patients. Without the addition of epinephrine, the effects of perineural and intravenous dexamethasone were equivalent concerning the duration of analgesia (mean difference 0.03 hours, 95% CI -0.17 to 0.24). However, with the addition of epinephrine, the analgesic duration of perineural dexamethasone versus intravenous dexamethasone was prolonged (mean difference 3.96 hours, 95% CI 2.66-5.27). Likewise, the impact of epinephrine was the same on the duration of motor block. The two routes of administration did not show any significant differences in the incidence of postoperative nausea and vomiting, nor on postoperative analgesic consumption at 24 hours. Our results show that perineural dexamethasone can prolong the effects of analgesic duration when compared to the intravenous route, only when epinephrine is coadministered. Without epinephrine, the two modalities show equivalent effect as adjuvants on regional anesthesia. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 2 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 1 | 50% |
| Members of the public | 1 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 48 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 48 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Postgraduate | 11 | 23% |
| Other | 6 | 13% |
| Student > Doctoral Student | 4 | 8% |
| Lecturer | 3 | 6% |
| Student > Master | 3 | 6% |
| Other | 7 | 15% |
| Unknown | 14 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 24 | 50% |
| Nursing and Health Professions | 2 | 4% |
| Engineering | 2 | 4% |
| Sports and Recreations | 1 | 2% |
| Unspecified | 1 | 2% |
| Other | 0 | 0% |
| Unknown | 18 | 38% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 November 2022.
All research outputs
#7,099,043
of 24,682,395 outputs
Outputs from Journal of Pain Research
#717
of 1,914 outputs
Outputs of similar age
#105,906
of 318,727 outputs
Outputs of similar age from Journal of Pain Research
#30
of 59 outputs
Altmetric has tracked 24,682,395 research outputs across all sources so far. This one has received more attention than most of these and is in the 69th percentile.
So far Altmetric has tracked 1,914 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 13.9. This one has gotten more attention than average, scoring higher than 61% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 318,727 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 65% of its contemporaries.
We're also able to compare this research output to 59 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 50% of its contemporaries.