Efficacy of Dexamethasone versus Dexmedetomidine Combined with Local Anaesthetics in Brachial Plexus Block: A Meta-Analysis and Systematic Review

Abstract

Background. Both dexamethasone and dexmedetomidine are commonly used local anaesthetic adjuvants in brachial plexus block to enhance the blocking effect. However, it is unclear which of the two drugs is more effective in a brachial plexus block. This article compares the effects of dexamethasone and dexmedetomidine combined with local anaesthetics in brachial plexus block through meta-analysis, availing information for current practice and future research. Methods. We conducted a search of the PubMed, Embase, Cochrane Library, and Web of Science databases to identify studies investigating the effects of dexamethasone and dexmedetomidine combined with local anaesthetics on brachial plexus block. The databases were searched from their inception to October 2021. Clinical randomized controlled trials were included. Two researchers independently conducted literature screening. The Cochrane System Review Manual was adopted for literature quality evaluation, whereas Stata 14.0 software aided in the meta-analysis. The duration of analgesia was the primary outcome indicator; whereas, the secondary outcome indicators included the duration of sensory block and motor block. Results. Seven articles were analysed, including 465 patients. Compared to the dexmedetomidine group, the dexamethasone group exhibited longer durations of analgesia (WMD = 111.29, 95% CI: 16.49–206.10, P = 0.021), sensory block (WMD = 173.20, 95% CI: 86.69–259.71, P < 0.0001), and motor block (WMD = 121.03, 95% CI: 12.87–229.20, P = 0.028). Conclusion. The present meta-analysis results affirm that dexamethasone is a better local anaesthetic adjuvant in brachial plexus block that enhances the blocking effect. Nevertheless, the existing heterogeneity warrants additional large-scale, multicentre, high-quality randomized controlled trials in the future for further verification and to provide more reliable clinical evidence.

The Comparison of Dexmedetomidine to Dexamethasone as Adjuvants to Bupivacaine in Ultrasound-Guided Infraclavicular Brachial Plexus Block in Upper Limb Surgeries

“…In terms of the adverse effects, a fall in heart rate and mean arterial pressure was noticed more commonly in the dexmedetomidine group in our study, as well as those of other studies (p = 0.006 [20] and p = 0.001 [19]). Dexmedetomidine also resulted in an increased level of sedation postoperatively, as was also found by other studies [18,19].…”

“…Both adjuvants have previously undergone extensive research [ 15 - 17 ]. However, the supraclavicular technique has been used in the majority of these trials to block the brachial plexus [ 18 ]. We found that adding 6 mg of dexamethasone as an adjuvant to 25 mL of 0.5% bupivacaine produced sensory and motor blocks that lasted noticeably longer than 75 mcg of dexmedetomidine, postoperative analgesia, and delayed time for the first rescue analgesic without causing unneeded adverse effects.…”

Local ozone injection compared to local glucocorticoid injection in carpal tunnel syndrome: A randomized controlled trial

“…Steroids act by reducing the local inflammation triggered by mechanical, immunological, or chemical factors. [ 13 ] Corticosteroids inhibit phospholipase A2, deactivating a proinflammatory cascade. [ 10 ] In addition, it has been reported that local CS may block type-C sensory nerve fibers.…”

Retracted: Efficacy of Dexamethasone versus Dexmedetomidine Combined with Local Anaesthetics in Brachial Plexus Block: A Meta‐Analysis and Systematic Review

“…Tis article has been retracted by Hindawi following an investigation undertaken by the publisher [1]. Tis investigation has uncovered evidence of one or more of the following indicators of systematic manipulation of the publication process:…”

“…This article has been retracted by Hindawi following an investigation undertaken by the publisher [ 1 ]. This investigation has uncovered evidence of one or more of the following indicators of systematic manipulation of the publication process: Discrepancies in scope Discrepancies in the description of the research reported Discrepancies between the availability of data and the research described Inappropriate citations Incoherent, meaningless and/or irrelevant content included in the article Peer-review manipulation …”