Introduction The analgesic comparison between perineural and intravenous dexamethasone on interscalene block for pain management after shoulder arthroscopy remains controversial. We conduct this meta-analysis to explore the influence of perineural versus intravenous dexamethasone on interscalene block for pain control after shoulder arthroscopy. Methods We have searched PubMed, Embase, Web of science, EBSCO and Cochrane library databases through April 2021 and included randomized controlled trials (RCTs) assessing the effect of perineural and intravenous dexamethasone on interscalene block in patients with shoulder arthroscopy. Results Five RCTs were included in the meta-analysis. Overall, compared with intravenous dexamethasone for shoulder arthroscopy, perineural dexamethasone led to similar block duration (SMD = 0.12; 95% CI − 0.12 to 0.35; P = 0.33), pain scores at 12 h (SMD = − 0.67; 95% CI − 1.48 to 0.15; P = 0.11), pain scores at 24 h (SMD = − 0.33; 95% CI − 0.79 to 0.14; P = 0.17), opioid consumption (SMD = 0.01; 95% CI − 0.18 to 0.19; P = 0.95) and incidence of nausea/vomiting (OR = 0.74; 95% CI 0.38–1.44; P = 0.38). Conclusions Perineural and intravenous dexamethasone demonstrated comparable pain relief after shoulder arthroscopy.
Introduction: The analgesic comparison of perineural with intravenous dexamethasone on interscalene block for pain management of shoulder arthroscopy remains controversial. We conduct a systematic review and meta-analysis to explore the influence of perineural with intravenous dexamethasone on interscalene block on the postoperative pain intensity of shoulder arthroscopy.Methods: We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through April 2021 for randomized controlled trials (RCTs) assessing the effect of perineural with intravenous dexamethasone on interscalene block for pain control of shoulder arthroscopy. This meta-analysis is performed using the random-effect model.Results: Five RCTs are included in the meta-analysis. Overall, compared with intravenous dexamethasone for shoulder arthroscopy, perineural dexamethasone leads to similar block duration (SMD=0.12; 95% CI=-0.12 to 0.35; P=0.33), pain scores at 12 h (SMD=-0.67; 95% CI=-1.48 to 0.15; P=0.11), pain scores at 24 h (SMD=-0.33; 95% CI=-0.79 to 0.14; P=0.17), opioid consumption (SMD=0.01; 95% CI=-0.18 to 0.19; P=0.95) and nausea/vomiting (OR=0.74; 95% CI=0.38 to 1.44; P=0.38).Conclusions: Perineural and intravenous dexamethasone demonstrated comparable pain control after shoulder arthroscopy when supplemented to interscalene block.
Introduction: The analgesic comparison of supraclavicular versus interscalene brachial plexus block (SCBB versus ISBB) for pain management of shoulder arthroscopy remains controversial. We conduct a systematic review and meta-analysis to explore the influence of SCBB versus ISBB on the postoperative pain intensity of shoulder arthroscopy. Methods We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through March 2021 for randomized controlled trials (RCTs) assessing the effect of SCBB versus ISBB on pain control of shoulder arthroscopy. This meta-analysis is performed using the random-effect model. Results Six RCTs are included in the meta-analysis. Overall, compared with ISBB for shoulder arthroscopy, SCBB leads to similar pain scores at 24 h (SMD = 0.07; 95% CI=-0.14 to 0.28; P = 0.52) and additional analgesic requirement (SMD=-0.22; 95% CI=-0.52 to 0.09; P = 0.16), but results in increased onset time of block (SMD = 1.77; 95% CI = 0.21 to 3.34; P = 0.25), decreased incidence of horner’s syndrome (OR = 0.25; 95% CI = 0.10 to 0.64; P = 0.003) and adverse events (OR = 0.25; 95% CI = 0.11 to 0.58; P = 0.001). Conclusions SCBB demonstrated comparable pain control after shoulder arthroscopy compared to ISBB, with lower incidence of adverse events.
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