Meta-analysis shows perineural dexamethasone prolongs analgesia by 2h in shoulder surgery, indicating cautious use.
Compared with the intravenous route, perineural dexamethasone modestly prolongs the duration of analgesia after single-shot interscalene block (approximately 2 h). However, the associated reductions in postoperative pain scores are small and unlikely to reach commonly cited MCID thresholds, rendering the overall clinical importance uncertain. These findings support cautious interpretation and individualized route selection rather than generalized claims of superiority.
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Wu et al. (2025) studied this question.
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