Does perineural dexamethasone prolong analgesia duration in patients undergoing brachial plexus blockade?
A 4 mg dose of perineural dexamethasone appears to be the ceiling dose for prolonging analgesia after brachial plexus blockade, though the current evidence quality is very low.
There is currently very low quality evidence that 4 mg of perineural dexamethasone represents a ceiling dose that prolongs analgesia duration by a mean period of 6 and 8 hours when combined with short-/intermediate- or long-acting local anesthetics, respectively. Additional data are needed to explore the threshold for this effect, particularly with doses below 4 mg. The risk of neurologic complications is probably not increased (very low evidence).
Kirkham et al. (Fri,) studied this question.
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