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Abstract
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Background and Aims Brachial plexus block (BPB) is commonly used for regional anaesthesia for superior limb orthopedic surgery. However, rebound pain after BPB resolution may limit its efficacy. This study aims to synthesize evidence on the effects of perineural dexamethasone on post-BPB rebound pain.
Methods A systematic search of MEDLINE, EMBASE, and Cochrane Library databases was conducted until April 18, 2023. The present study incorporates randomized and non-randomized controlled trials, which evaluate the outcomes of rebound pain in patients undergoing BPB procedures with perineural dexamethasone as compared to control groups. Mean values of visual analogue scale (VAS) at 12, 24, and 48 hours post-surgery were extracted, and mean difference (MD) was calculated. Statistical analyses were performed using RevMan 5.4. Our study is registered in the PROSPERO under protocol CRD42023418469.
Results The literature search identified 1160 studies, out of which 4 studies met the inclusion criteria, involving a combined population of 307 patients. Significant differences in the VAS scores were observed between the perineural dexamethasone and control groups at 12 hours (figure 1). However, there were no significant differences in VAS scores between the two groups at 24 hours (figure 2) and 48 hours (figure 3).
Mean values of visual analogue scale (VAS) at 12 hours post-surgery
Mean values of visual analogue scale (VAS) at 24 hours post-surgery
Mean values of visual analogue scale (VAS) at 48 hours post-surgery
Conclusions The results of our study indicate that the administration of perineural dexamethasone during BPB may lead to reduction in rebound pain 12 hours after the surgical procedure. However, our analysis did not reveal any statistically significant differences between the experimental and control groups at 24 and 48 hours postoperatively.